Teófilo Vanessa S G, Matos Pedro M M, Carvalho Isabel S, Pinho Paulo R A, Ribeiro Rui A M, Moreira Salomé M, Miller Mariana S F, Pinelas Sofia M, Azevedo Catarina I S, Silva Ana F F, Norton Pedro M P N S
Occupational Health Service, Unidade Local de Saúde de São João, E.P.E., Porto, Portugal.
Occupational Health Service, Unidade Local de Saúde do Alto Ave, E.P.E., Guimarães, Portugal.
Porto Biomed J. 2025 Aug 5;10(4):e298. doi: 10.1097/j.pbj.0000000000000298. eCollection 2025 Sep-Oct.
BACKGROUND: Malignant mesothelioma is a rare, aggressive neoplasm arising from mesothelial cells of the pleura, peritoneum, pericardium, or tunica vaginalis. The primary risk factor is asbestos exposure, particularly occupational. Given its long latency period, the persistence of asbestos sources despite legislation, and recognition of other risk factors, new cases are expected to emerge annually. This study retrospectively analyses the incidence and characteristics of mesothelioma cases diagnosed over 36 years in a hospital in northern Portugal, along with a sociodemographic description of this population. METHODS: Patients diagnosed with mesothelioma (International Classification of Diseases for Oncology morphological code M-905x/3) were identified through the National Oncological Registry. Collected data included sex, age at diagnosis, year of diagnosis, tumor location, and histological subtype. Medical records were reviewed for relevant personal and occupational histories. RESULTS: A total of 82 patients were diagnosed with mesothelioma between 1988 and 2023: 11 cases up to 1999, 29 from 2000 to 2011, and 42 from 2012 to 2023. Of them, 69.51% (n = 57) were male, with a mean age at diagnosis of 67 ± 13 years [range: 28-85]. Diagnoses occurred in 12.20% (n = 10) younger than 50 years, 35.37% (n = 29) between 50-69, and 52.44% (n = 43) older than 70 years. Pleural involvement was observed in 86.59% (n = 71) and peritoneal in 13.41% (n = 11). Histological subtypes included epithelioid (34.15%; n = 28), biphasic (19.51%; n = 16), sarcomatoid (14.63%; n = 12), and unknown (31.71%; n = 26). Occupational history was identifiable in 40.24% (n = 33); 20 had probable asbestos exposure. Two cases were linked to nonoccupational causes. CONCLUSIONS: Despite asbestos bans, mesothelioma remains a public health concern due to its latency and persistent exposure sources. Cases in younger individuals or women highlight the need to investigate environmental contamination or alternative etiologies. Broader, prospective studies are needed to better understand the disease's evolution and determinants.
背景：恶性间皮瘤是一种罕见的侵袭性肿瘤，起源于胸膜、腹膜、心包或鞘膜的间皮细胞。主要危险因素是石棉暴露，尤其是职业性暴露。鉴于其潜伏期长、尽管有相关立法但石棉来源仍持续存在以及对其他危险因素的认识，预计每年都会出现新病例。本研究回顾性分析了葡萄牙北部一家医院36年来诊断的间皮瘤病例的发病率和特征，并对该人群进行了社会人口统计学描述。 方法：通过国家肿瘤登记处识别出诊断为间皮瘤（国际肿瘤疾病分类形态学代码M-905x/3）的患者。收集的数据包括性别、诊断时年龄、诊断年份、肿瘤位置和组织学亚型。查阅病历以获取相关的个人和职业病史。 结果：1988年至2023年期间，共有82例患者被诊断为间皮瘤：1999年及以前有11例，2000年至2011年有29例，2012年至2023年有42例。其中，69.51%（n = 57）为男性，诊断时的平均年龄为67±13岁[范围：28 - 85岁]。50岁以下患者的诊断占12.20%（n = 10），50 - 69岁患者占35.37%（n = 29），70岁以上患者占52.44%（n = 43）。86.59%（n = 71）观察到胸膜受累，13.41%（n = 11）为腹膜受累。组织学亚型包括上皮样（34.15%；n = 28）、双向性（19.51%；n = 16）、肉瘤样（14.63%；n = 12）和未知（31.71%；n = 26）。40.24%（n = 33）的患者有可识别的职业病史；20例可能有石棉暴露。2例与非职业原因有关。 结论：尽管已禁止使用石棉，但由于间皮瘤的潜伏期和持续暴露源，它仍然是一个公共卫生问题。年轻个体或女性中的病例凸显了调查环境污染或其他病因的必要性。需要进行更广泛的前瞻性研究，以更好地了解该疾病的演变和决定因素。
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