Dorward A J, Stack B H
Br J Dis Chest. 1981 Oct;75(4):397-402. doi: 10.1016/0007-0971(81)90027-9.
Thirty-two patients seen in one area between 1974 and 1980 with a diagnosis of malignant pleural mesothelioma are reviewed retrospectively. Asbestos contact, often in the shipyards, was found in 80%. The average age at diagnosis was 64 years and chest pain or breathlessness were the most common initial symptoms. Radiology usually confirmed a pleural effusion, but rarely also showed pleural plaques or asbestosis. The most useful diagnostic investigation was pleural biopsy, with a 59% success rate. Post mortem examinations showed widespread infiltration of adjacent tissues in many, with haematogenous metastases in 52%. Prognosis was poor, with an average survival of 40 weeks from presentation. No treatment improved life expectancy. Thoracotomy was followed by painful chest wall masses. The incidence of mesothelioma in our area is six times higher than in the rest of Scotland. As the disease has a long latent period between asbestos exposure and appearance, it will be many years before this rate is significantly reduced.
对1974年至1980年间在某一地区确诊为恶性胸膜间皮瘤的32例患者进行了回顾性研究。发现80%的患者曾接触过石棉，接触地点通常在造船厂。确诊时的平均年龄为64岁，胸痛或呼吸急促是最常见的初始症状。放射学检查通常证实有胸腔积液，但很少也显示有胸膜斑或石棉沉着病。最有用的诊断检查是胸膜活检，成功率为59%。尸检显示许多患者的相邻组织有广泛浸润，52%有血行转移。预后很差，从出现症状起平均存活40周。没有任何治疗方法能延长预期寿命。开胸手术后出现疼痛的胸壁肿块。我们地区间皮瘤的发病率比苏格兰其他地区高六倍。由于该病在接触石棉和发病之间有很长的潜伏期，要使这一发病率显著降低还需要很多年。
