Scherpereel Arnaud
CHU de Lille, institut Pasteur de Lille, université de Lille, pneumologie et oncologie thoracique, CIIL, Inserm U1019, 59000 Lille, France.
Presse Med. 2016 Jan;45(1):117-32. doi: 10.1016/j.lpm.2015.12.011. Epub 2016 Jan 26.
Previous occupational asbestos exposure (more rarely environmental or domestic exposure) may induce various pleural and/or pulmonary, benign or malignant diseases, sometimes with a very long latency for malignant mesothelioma (MM). Asbestos has been widely extracted and used in Western countries and in emerging or developing countries, resulting in a peak of MM incidence in France around 2020 and likely in a world pandemic of asbestos-induced diseases. These patients have mostly benign respiratory diseases (pleural plugs) but may also be diagnosed with lung cancer or malignant pleural mesothelioma, and have a global poor outcome. New therapeutic tools (targeted therapies, immunotherapy…) with first promising results are developed. However, it is crucial to obtain a full ban of asbestos use worldwide, and to do a regular follow-up of asbestos-exposed subjects, mostly if they are already diagnosed with benign respiratory diseases. Finally, new cancers (larynx and ovary) were recently added to the list of asbestos-induced tumors.
既往职业性石棉暴露(较少见的是环境或家庭暴露)可能诱发各种胸膜和/或肺部的良性或恶性疾病,有时恶性间皮瘤(MM)的潜伏期很长。石棉在西方国家以及新兴或发展中国家被广泛开采和使用,导致法国MM发病率在2020年左右达到峰值,石棉所致疾病可能在全球范围内流行。这些患者大多患有良性呼吸道疾病(胸膜斑),但也可能被诊断为肺癌或恶性胸膜间皮瘤,总体预后较差。正在开发具有初步良好效果的新治疗工具(靶向治疗、免疫治疗等)。然而,至关重要的是在全球范围内全面禁止使用石棉,并对接触石棉的人群进行定期随访,尤其是那些已被诊断患有良性呼吸道疾病的人群。最后,新的癌症(喉癌和卵巢癌)最近被列入石棉所致肿瘤名单。