疑似石綿相關之惡性間皮瘤個案報告暨文獻回顧

Suspect Asbestos Related Malignant Mesothelioma: A Case Report and Review of Literature

吳立偉(Li-Wei Wu) ； 江昇達(Sheng-Ta Chiang) ； 王鐘慶(Chung-Ching Wang) ； 林易申(I-Shen Lin) ； 羅慶徽(Ching-Hui Loh) ； 劉紹興(Saou-Hsing Liou) ； 陳永煌(Yeong-Hwang Chen)

《中華職業醫學雜誌》 18卷1期 (2011/01) Pp. 1-6

https://doi.org/10.30027/CJOM.201101.0001

摘要

回顧五十年來台灣已報告過的肺部職業疾病，塵肺症算是相當古老也是最常見的職業性疾病之一，此乃因為工業化的過程中，因採礦作業造成許多的肺纖維化及相關的疾病。一般來說，職業性肺病包括了矽肺症、石綿塵肺症、煤肺症、棉花肺症、職業性氣喘、過敏性肺泡炎、感染性肺病及肺癌等。其中石綿暴露相關疾病包括肺部纖維化、肋膜斑、肋膜增厚及肋膜積水等，同時罹患惡性間皮瘤及肺癌的比例升高，因此石綿暴露被認為是「工業影響健康最不幸的悲劇之一」，西方先進國家紛紛立法減少石綿的使用。國內石綿造成惡性間皮瘤的個案報告並不多，惡性間皮瘤是一種侵略性很強的腫瘤，是由肋膜上間皮細胞癌化所形成的，潛伏期平均約四十年以上，大部分得惡性間皮瘤的患者為男性且平均年齡約50到70歲。本文報告一位39歲男性木工，由於過去二十餘年疑似長期大量接觸含石綿之防火建材，而罹患惡性間皮瘤之病例，並回顧相關文獻希望能提供給醫師診斷及處理職業性石綿肺病合併惡性間皮瘤的方法。在嚴格限制及規範石綿使用之下，期望石綿相關肺部疾病能漸漸減少。

關鍵字

石綿 ； 間皮瘤 ； 肋膜纖維化 ； 肺癌

並列摘要

According to the occupational lung disease reported in the past fifty years, pneumoconiosis remains the most common occupational disease in Taiwan. This is because of the process of industrialization, resulted in many cases of pulmonary fibrosis and occupational lung diseases, including silicosis, asbestos related lung diseases, coal lung disease, cotton lung disease, occupational asthma, hypersensitivity pneumonitis, and lung cancer. Asbestos related lung diseases are including pulmonary fibrosis, pleural plaques, pleural thickening and pleural effusion, with increasing incident rate of malignant mesothelioma. Malignant mesothelioma is a highly aggressive tumor with the average latency period, about 40 years or more. Most of the malignant mesothelioma patients are males and the average age ranges from 50 to 70 years. We reported a 39-year-old young male carpenter with a long-term exposure of a large number of suspected asbestos-containing materials over the past 20 years, suffering from malignant mesothelioma of left pleura. The reviews of the literature were available to doctors and hope to early diagnosis and treatment of malignant mesothelioma. After restrictions and regulations in the use of asbestos, asbestos-related lung diseases and malignant mesothelioma could be reduced gradually. Recent advances in understanding the mechanisms of malignant mesothelioma pathogenesis will eventually lead to novel preventive and therapeutic strategies for malignant mesothelioma patients.

並列關鍵字

Asbestos ； mesothelioma ； pleural fibrosis ； lung cancer