Pleura mesothelioma

Relatively rare tumor, characterized by diffuse infiltrative growth. The risk of the disease is significantly higher in patients with asbestosis. The literary figures in the U.S., where the effects of asbestos are subject to a professional 7-8 million people, the incidence of malignant mesothelioma of 0,1-0,2 per 100 thousand inhabitants and the annual increases (peritoneum and pleura affected equally often). Since 1976 in France this pathology refers to occupational diseases (B. Saillard et al., 1977). The latent period of malignant mesothelioma is 20-30 years.

Pathogenesis pleura mesothelioma insufficiently explored, however, found that asbestos fibers are tropnost to seroznym shells. Of the respiratory tract, they migrate to pleurisy, which can accumulate in large quantities and serve as trigger for the development of tumors. With the lymph flow, towards the parietal pleura, tumor cells implanted in it, and gradually spread across the surface. Thus, the tumor involves both visceral or parietal pleura sheets, leading to the circulation of lymph, the rapid accumulation of exudation in the pleural cavity.

Certainly, the diagnosis of mesothelioma pleura difficult. Its non-clinical manifestations vary depending on the incidence of breast cancer patients and the localization of lesions.

The diagnosis of mesothelioma pleura determined with the use of biopsy pleura, electron microscopy and immunohistochemical study. Surgical treatment of mesothelioma are rare (in 7-10% of patients), and 2-year survival rate after surgery is only 10-35%. Radiation therapy is usually conducted to reduce the pain syndrome and has no effect on survival. Among cytostatics, active against mesothelioma, mention should be made of platinum derivatives, gemtsitabin, antratsikliny. The use of these drugs leads to the objective effect at 20-48% of patients. It should be noted gemtsitabin combination + cisplatin (karboplatin), doxorubicin + cisplatin + mitomycine C + cisplatin alimta. Perspective may also be a combination of new cytostatics, as well as their combination with targetnymi drugs. The important prognostic factor is the young age epitelioidny type of tumor, as well as the effect of adjuvant chemotherapy after radical plevropnevmonektomy.