Department of Respiratory Medicine, Okayama Rosai Hospital, Okayama, Japan.
Cancer Sci. 2012 Mar;103(3):483-90. doi: 10.1111/j.1349-7006.2011.02165.x. Epub 2012 Jan 9.
In the present study, malignant mesothelioma (MM) cases in Japan were investigated retrospectively. We extracted records for 6030 cases of death due to MM between 2003 and 2008 to clarify the clinical features of MM, including its association with asbestos exposure (AE). Of all these cases, a clinical diagnosis of MM was confirmed for 929. The origin of MM included the pleura in 794 cases (85.5%), the peritoneum in 123 cases (13.2%), the pericardium in seven cases (0.8%), and the testicular tunica vaginalis in five cases (0.5%). The histological subtypes of MM included 396 epithelioid (55.9%), 154 sarcomatoid (21.7%), 126 biphasic (17.8%), and 33 cases (4.7%) classified as "other types". Of all the MM cases, AE was indicated in 76.8% and pleural plaques were detected in 34.2%. The number of asbestos particles was determined in 103 cases of MM. More than 1000 asbestos particles per gram dried lung tissue were detected in 74.8% of cases and more than 5000 particles were detected in 43.7% of cases. We compared patient characteristics and the diagnostic procedures for MM before and after the "Kubota shock". Compared with the early phase of this study (2003-2005), the median age at diagnosis of MM was higher, the number of cases without definite diagnosis of MM was lower, the proportion of cases diagnosed by thoracoscopy was higher, and the percentage of cases in which the occupational history was described in the medical records was significantly higher in the later phase (2006-2008). Our study confirmed that more than 70% of MM cases in Japan are associated with AE. The "Kubota shock" may affect some features pertaining to MM.
在本研究中，回顾性调查了日本的恶性间皮瘤（MM）病例。我们提取了 2003 年至 2008 年间因 MM 死亡的 6030 例记录，以阐明 MM 的临床特征，包括其与石棉暴露（AE）的关系。在所有这些病例中，929 例临床诊断为 MM。MM 的起源包括 794 例胸膜（85.5%）、123 例腹膜（13.2%）、7 例心包（0.8%）和 5 例睾丸鞘膜（0.5%）。MM 的组织学亚型包括 396 例上皮样（55.9%）、154 例肉瘤样（21.7%）、126 例双相型（17.8%）和 33 例（4.7%）归类为“其他类型”。所有 MM 病例中，76.8%有 AE 提示，34.2%有胸膜斑。103 例 MM 病例测定了石棉颗粒数。74.8%的病例每克干燥肺组织中检测到超过 1000 个石棉颗粒，43.7%的病例中检测到超过 5000 个石棉颗粒。我们比较了“久保田冲击”前后 MM 患者特征和 MM 的诊断程序。与本研究的早期阶段（2003-2005 年）相比，MM 的诊断中位年龄更高，无明确 MM 诊断的病例数更低，胸腔镜诊断的病例比例更高，病历中描述职业史的病例百分比明显更高。在晚期（2006-2008 年）。我们的研究证实，日本超过 70%的 MM 病例与 AE 有关。“久保田冲击”可能会影响与 MM 相关的某些特征。
