Hulks G, Thomas J S, Waclawski E
Department of Respiratory Medicine, Western Infirmary, Glasgow.
Thorax. 1989 Jun;44(6):496-500. doi: 10.1136/thx.44.6.496.
This study reviews all histologically proved cases of malignant pleural mesothelioma seen in the western district of Glasgow during 1980-6. Sixty eight cases were identified (three female) with an age range at presentation of 48-85 (mean 68.9) years. Asbestos exposure was identified in 54 (80%) of the patients, most of whom had been shipyard workers. Pain and dyspnoea were the most common presenting symptoms. Pleural effusion was found in 57 (84%) of the patients, in a ratio of 2.6 right:left. The median survival was only 30 weeks from the time of presentation. Prognosis was significantly better for those presenting with dyspnoea than for those with pain (median survival 44 v 22 weeks). Postmortem examination was performed in 40 cases and metastatic disease found in more than three quarters. There was no significant difference between the incidence of the various tumour cell types or any relation between cell type and survival or the incidence of metastatic disease. A substantial increase in cases of malignant pleural mesothelioma has been found in an area of already high incidence. The use of rigorous histological criteria to determine histological cell type has shown that this previously valued variable is of no discriminatory value with regard to disease activity or survival.
本研究回顾了1980年至1986年间在格拉斯哥西区经组织学证实的所有恶性胸膜间皮瘤病例。共确诊68例（3例女性），就诊时年龄范围为48至85岁（平均68.9岁）。54例（80%）患者有石棉接触史，其中大多数曾是造船厂工人。疼痛和呼吸困难是最常见的就诊症状。57例（84%）患者发现胸腔积液，左右比例为2.6:1。从就诊时起，中位生存期仅为30周。呼吸困难患者的预后明显好于疼痛患者（中位生存期分别为44周和22周）。40例进行了尸检，超过四分之三发现有转移性疾病。各种肿瘤细胞类型的发生率之间无显著差异，细胞类型与生存期或转移性疾病的发生率之间也无任何关联。在一个本就发病率高的地区，恶性胸膜间皮瘤病例有显著增加。使用严格的组织学标准来确定组织学细胞类型表明，这个以前被重视的变量在疾病活动或生存期方面没有鉴别价值。
