Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
Department of Respiratory and Critical Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Medicina (Kaunas). 2022 Dec 19;58(12):1874. doi: 10.3390/medicina58121874.
Malignant pleural mesothelioma (MPM) is an aggressive and rare malignant pleural tumor. MPM patients diagnosed in Beijing Chaoyang Hospital and Beijing Tongren Hospital were the focus of this study. We collected and analyzed the histological, radiological, and metabolic features of MPM patients. At the same time, Cox univariable and multivariable analyses were used to explore the laboratory risk factors affecting the prognosis of MPM patients. A total of 129 MPM patients were included in this study. MPM includes three main histological subtypes: epithelioid, sarcomatoid and biphasic. Among them, epithelial subtypes accounted for the highest proportion. Calretinin, Wilms' tumor gene (WT1), cytokeratin 5/6 (CK5/6), and D2-40 were the most useful mesothelial markers to support a MPM diagnosis. The imaging features of MPM patients are pleural thickening and pleural effusion. In PET-CT, the affected pleura showed obvious high uptake of tracer, and the degree was related to the specific subtype. The median follow-up time was 55.0 (30.0, 94.0) months. A total of 92 (71.3%) patients died during follow-up. The median survival time of patients was 21.0 (9.0, 48.0) months. The Cox multivariable analysis showed that age [hazard ratio (HR), 1.824; 95% confidence interval (CI) 1.159-2.872; = 0.009; uncorrected], ESR (HR, 2.197; 95% CI 1.318-3.664; = 0.003; with Bonferroni correction), lymphocytes (HR, 0.436; 95% CI 0.258-0.737; = 0.002; with Bonferroni correction), platelets (HR, 1.802; 95% CI 1.084-2.997; = 0.023; uncorrected) and total protein (HR, 0.625; 95% CI 0.394-0.990; = 0.045; uncorrected) were independent risk factors for prognosis, after adjusting for confounding factors. Age, ESR, lymphocytes, platelets and total protein may be related to the prognosis of MPM patients. Summarizing the histological, radiological, and metabolic features of MPM patients in the two centers can increase clinicians' understanding of this rare tumor.
恶性胸膜间皮瘤（MPM）是一种侵袭性和罕见的恶性胸膜肿瘤。本研究的重点是在北京朝阳医院和北京同仁医院诊断的 MPM 患者。我们收集和分析了 MPM 患者的组织学、影像学和代谢特征。同时，采用 Cox 单变量和多变量分析探讨影响 MPM 患者预后的实验室危险因素。本研究共纳入 129 例 MPM 患者。MPM 包括三种主要的组织学亚型：上皮样、肉瘤样和双相型。其中，上皮亚型占比最高。钙视网膜蛋白、Wilms 瘤基因（WT1）、细胞角蛋白 5/6（CK5/6）和 D2-40 是最有助于支持 MPM 诊断的间皮标志物。MPM 患者的影像学特征为胸膜增厚和胸腔积液。在 PET-CT 中，受累胸膜显示明显的示踪剂摄取增高，程度与特定亚型有关。中位随访时间为 55.0（30.0，94.0）个月。随访期间共有 92 例（71.3%）患者死亡。患者中位生存时间为 21.0（9.0，48.0）个月。Cox 多变量分析显示，年龄[风险比（HR），1.824；95%置信区间（CI）1.159-2.872； = 0.009；未校正]、ESR（HR，2.197；95% CI 1.318-3.664； = 0.003；校正 Bonferroni 后）、淋巴细胞（HR，0.436；95% CI 0.258-0.737； = 0.002；校正 Bonferroni 后）、血小板（HR，1.802；95% CI 1.084-2.997； = 0.023；未校正）和总蛋白（HR，0.625；95% CI 0.394-0.990； = 0.045；未校正）是预后的独立危险因素，在调整混杂因素后。年龄、ESR、淋巴细胞、血小板和总蛋白可能与 MPM 患者的预后相关。总结两个中心 MPM 患者的组织学、影像学和代谢特征，可以增加临床医生对这种罕见肿瘤的认识。
