Kondola Sanjana, Manners David, Nowak Anna K
Department of Medical Oncology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
Ther Adv Respir Dis. 2016 Jun;10(3):275-88. doi: 10.1177/1753465816628800. Epub 2016 Feb 12.
Malignant pleural mesothelioma (MPM) represents a significant diagnostic and therapeutic challenge and is almost always a fatal disease. Imaging abnormalities are common, but have a limited role in distinguishing mesothelioma from metastatic pleural disease. Similarly, minimally invasive biomarkers have shown promise but also have limitations in the diagnosis of mesothelioma. In experienced centers, cytology and immunohistochemistry are now sufficient to diagnose the epithelioid subtype of mesothelioma, which can reduce the need for more invasive diagnostic investigations. Prognosis of MPM is modestly impacted by oncological treatments. Chemotherapy with cisplatin and pemetrexed is considered the standard of care, though the addition of bevacizumab to the platinum doublet may be the new standard of care. New targeted therapies have demonstrated some promise and are being addressed in clinical trials. This review focuses on the current data on the diagnostic and therapeutic issues of MPM.
恶性胸膜间皮瘤（MPM）是一个重大的诊断和治疗挑战，几乎总是一种致命疾病。影像学异常很常见，但在鉴别间皮瘤与转移性胸膜疾病方面作用有限。同样，微创生物标志物虽已显示出前景，但在间皮瘤诊断中也存在局限性。在经验丰富的中心，细胞学和免疫组化目前已足以诊断间皮瘤的上皮样亚型，这可减少对侵入性更强的诊断检查的需求。MPM的预后受到肿瘤治疗的适度影响。顺铂和培美曲塞化疗被视为标准治疗方案，不过在铂类双联化疗中添加贝伐单抗可能成为新的标准治疗方案。新的靶向治疗已显示出一些前景，正在临床试验中进行研究。本综述聚焦于MPM诊断和治疗问题的当前数据。
