Rüttner J R
Schweiz Med Wochenschr. 1983 Mar 12;113(10):346-51.
Malignant mesothelioma is a rare neoplasm of rapidly lethal course arising primarily in the pleura and less often in the peritoneum. In the majority of cases the disease is closely related to occupational exposure to asbestos. The latency period, calculated from the first contact with asbestos to the appearance of mesothelioma, is generally in the order of 20 years or more irrespective of the duration of exposure. A causal relationship can be established with certainty only by a careful history and positive tissue analysis for the presence of asbestos. The author's own series of 48 pleural mesotheliomas comprises 39 cases involving occupational exposure to asbestos, 6 others with asbestos demonstrable in pulmonary tissue but no discernible source in the history, and 3 where no relation to asbestos could be established at all. Although a dose-response relation may be assumed for asbestos as for all other carcinogens, the lack of data on asbestos dust concentrations at former places of work rendered determination of the minimal noxious dose difficult or impossible. It also remains unclear whether the various asbestos types, such as chrysotile and amphiboles, differ in pathogenic effect. It is hoped that careful registration and continuing study of mesotheliomas will shed further light on their relationship to asbestos and on the possible hazards of the mineral to the general population.
恶性间皮瘤是一种罕见的肿瘤，病程进展迅速，常致人死亡，主要发生于胸膜，较少见于腹膜。在大多数情况下，该病与职业性接触石棉密切相关。从首次接触石棉到间皮瘤出现的潜伏期，一般为20年或更长时间，与接触时间长短无关。只有通过详细的接触史和对组织进行石棉阳性分析，才能确切建立因果关系。作者本人收集的48例胸膜间皮瘤病例中，39例有职业性石棉接触史，6例肺部组织可检测到石棉，但接触史中无明显接触源，3例则完全无法确定与石棉有关。尽管对于石棉如同对所有其他致癌物一样，可假定存在剂量反应关系，但由于缺乏既往工作场所石棉粉尘浓度的数据，难以或无法确定最小有害剂量。此外，各种石棉类型，如温石棉和闪石，其致病作用是否存在差异也尚不清楚。希望对间皮瘤进行仔细登记并持续研究，能进一步阐明其与石棉的关系以及该矿物质对普通人群可能存在的危害。
