Bianchi Claudio, Bianchi Tommaso
Center for the Study of Environmental Cancer, Italian League against Cancer, Hospital of Monfalcone, Italy.
Ind Health. 2007 Jun;45(3):379-87. doi: 10.2486/indhealth.45.379.
Mesothelioma incidence varies markedly from one country to another. The highest annual crude incidence rates (about 30 cases per million) are observed in Australia, Belgium, and Great Britain. A lot of data indicate a relationship between mesothelioma and asbestos. The hot areas for mesothelioma exactly correspond to the sites of industries with high asbestos use, such as shipbuilding and asbestos-cement industry. However, in many countries with high asbestos consumption, mesothelioma incidence is low. The reasons for this fact are not clear. The latency periods elapsing between first exposure to asbestos and development of mesothelioma are mostly longer than 40 yr. An inverse relationship exists between intensity of asbestos exposure and length of the latency period. Mesothelioma generally develops after long-time exposures to asbestos. Some recent studies show that the risk increases with the duration of exposure. Possible co-factors in the pathogenesis of asbestos-related mesothelioma include genetic predisposition, diets poor in fruit and vegetables, viruses, immune impairment, recurrent serosal inflammation. The study of co-morbidity in mesothelioma could give an insight into the pathogenesis of the tumor. While a levelling-off in mesothelioma incidence has been registered in some countries, a worsening of the epidemic is predictable in large parts of the world.
间皮瘤的发病率在不同国家之间存在显著差异。澳大利亚、比利时和英国的年粗发病率最高（约为每百万人口30例）。大量数据表明间皮瘤与石棉之间存在关联。间皮瘤的高发地区恰好与石棉高用量行业的所在地相对应，如造船业和石棉水泥行业。然而，在许多石棉消费量高的国家，间皮瘤发病率却很低。这一事实的原因尚不清楚。首次接触石棉到间皮瘤发病之间的潜伏期大多超过40年。石棉接触强度与潜伏期长短呈反比关系。间皮瘤通常在长期接触石棉后发病。最近的一些研究表明，风险随着接触时间的延长而增加。与石棉相关的间皮瘤发病机制中可能的共同因素包括遗传易感性、水果和蔬菜摄入不足的饮食、病毒、免疫功能损害、反复的浆膜炎症。对间皮瘤合并症的研究有助于深入了解肿瘤的发病机制。虽然一些国家的间皮瘤发病率已趋于平稳，但在世界大部分地区，这种流行病的恶化是可以预见的。
