Institute of Cancer and Genetics, School of Medicine, Cardiff University, United Kingdom.
Arch Pathol Lab Med. 2012 Mar;136(3):262-7. doi: 10.5858/arpa.2011-0039-RA.
Despite asbestos being identified as the single most important cause of malignant mesothelioma, the tumor is known to occur in only 10% to 20% of heavily exposed individuals. In addition, about 20% of the patients have no history of asbestos exposure even after detailed assessment. Therefore, there has been speculation for some time that asbestos alone may not be sufficient to cause mesothelioma and that other factors may be involved either as cocarcinogens or as independent mechanisms of cancer causation.
To give a brief review of nonasbestos fiber erionite and therapeutic radiation as 2 established examples of asbestos-independent mechanisms, of the potential emerging role of man-made fibers such as carbon nanotubes, and of polyoma virus SV40 (simian virus 40) as a potential example of the cocarcinogenic mode of involvement.
Relevant recent literature has been surveyed to portray and provide the evidence in favor of the examples.
Erionite has emerged as the most important example of nonasbestos-mediated cause of mesothelioma in regions such as Turkey where exposure to this type of fiber is highly prevalent. Recently, the polyoma virus SV40 has been unexpectedly discovered as an effective cocarcinogen of asbestos in the causation of animal mesothelioma, though despite considerable research, its potential role in human mesothelioma remains unproven.
尽管石棉被认为是恶性间皮瘤的唯一最重要原因，但已知这种肿瘤仅在 10%至 20%的重度暴露个体中发生。此外，即使经过详细评估，仍有约 20%的患者没有石棉暴露史。因此，有一段时间人们猜测，石棉本身可能不足以引起间皮瘤，可能还有其他因素作为协同致癌物或癌症发生的独立机制参与其中。
简要回顾 2 种已确立的非石棉纤维-蓝石棉和放射性治疗作为石棉非依赖性机制的例子，以及人造纤维（如碳纳米管）和多瘤病毒 SV40（猿猴病毒 40）作为协同致癌模式参与的潜在新兴作用的例子。
调查了相关的最新文献，以描绘和提供支持这些例子的证据。
在土耳其等地区，蓝石棉已成为非石棉介导间皮瘤的最重要例子，在这些地区，这种纤维的暴露非常普遍。最近，多瘤病毒 SV40 被意外发现是石棉引起动物间皮瘤的有效协同致癌物，尽管进行了大量研究，但它在人类间皮瘤中的潜在作用仍未得到证实。
