Boutin C, Viallat J R, Rey F, Astoul P, Seitz B
Service de pneumologie, hôpital de la Conception, Marseille.
Rev Prat. 1990 Sep 11;40(20):1846-50.
The early diagnosis of mesothelioma rests on very common clinical evidence, including pleuritis of recent onset, history of contact with asbestos, chest pain, often moderate loss of weight and slight changes in old pleural fluid cytology, 24% for Adams' needle biopsy and 93% for thoracoscopy, where the only negative results are obtained in patients with adhesive pleuritis. Prognosis depends on several factors, the most favourable ones being the histological type of the lesion (epithelial or mixed), the fact that it is limited to the parietal or diaphragmatic pleural and, on the patient's side and accessorily: female sex, lack of exposure to asbestos, age under 50, good general condition and absence of chest pain.
间皮瘤的早期诊断基于非常常见的临床证据,包括近期出现的胸膜炎、接触石棉的病史、胸痛、常伴有中度体重减轻以及陈旧性胸水细胞学的轻微变化,亚当斯针吸活检的阳性率为24%,胸腔镜检查的阳性率为93%,仅在粘连性胸膜炎患者中出现阴性结果。预后取决于几个因素,最有利的因素是病变的组织学类型(上皮型或混合型)、病变局限于壁层或膈胸膜,以及患者自身的因素,辅助因素包括:女性、未接触石棉、年龄小于50岁、一般状况良好且无胸痛。