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间皮瘤(1)

(2009-06-24 23:37:06)
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健康

Pleural Mesothelioma胸膜间皮瘤

Pleural mesothelioma is the most common type of mesothelioma and has been studied to a far greater degree than any of the other forms of the disease. The vast majority of treatment regimens and all of the staging guidelines currently utilized in the diagnosis of mesothelioma are based on pleural mesothelioma. Because of this, when most people speak of “mesothelioma”, they are usually speaking of malignant pleural mesothelioma. After pleural mesothelioma, peritoneal mesothelioma accounts for the majority of other diagnoses. 

胸膜间皮瘤是间皮瘤的最常见类型,对它的研究远深于其它形式疾病的研究。应用在间皮瘤的绝大多数治疗方案和所有的分期指南依据于胸膜间皮瘤。正应为如此,当大多数人们说道间皮瘤时,他们常是在说恶性胸膜间皮瘤。在胸膜间皮瘤之后,腹膜间皮瘤在其它诊断中占多数。

Function of the Pleura胸膜的功能

Pleural mesothelioma occurs when one of the pleura in the chest cavity becomes malignant. The pleurae are serous membranes, which mean they secrete a lubricating fluid, called serous fluid. There are two pleurae in the chest cavity and their job is to protect and cushion the lung by secreting fluid that allows the lung to move smoothly within the chest cavity when breathing. While they certainly serve an important purpose, each pleura can be removed if it becomes damaged or diseased. The ease of which it can be removed is dependant on which of the pleural surfaces becomes malignant: the parietal pleura or the visceral pleura.

胸膜间质瘤胸腔的一部分胸膜恶变后。胸膜为浆膜,这意味着它们可以分泌润滑液体,即浆液。胸腔两层胸膜,它们通过分泌液体保护和缓冲肺脏使得肺可以随呼吸在胸腔里平稳的运动。尽管它们有重要的作用,如果它们受损或发生疾病时可以被移除。解除那部分决定于病变部位:脏层胸膜还是壁层胸膜。

The parietal pleura lines the inside of the chest and covers the ribs and the pericardium. It is a fairly thin tissue between two and three millimeters thick and is the more easily removed of the two pleural surfaces. At a single millimeter in thickness, the visceral pleura is barely half the width of the parietal pleura. It directly covers the lung itself, which makes extraction of the visceral pleura without subsequent damage to the lung very difficult.

壁层胸膜在胸壁内侧覆盖肋骨和心包膜。它是两到三微米厚的薄层组织,在两个胸膜表面更易被移除。脏层胸膜一微米厚仅是壁层胸膜宽度的一半。它直接覆盖于肺表面,使得移除脏层胸膜而无肺损伤非常困难。

Development of Pleural Mesothelioma 胸膜间皮瘤的发展

While science has conclusively shown that mesothelioma is caused only by asbestos exposure, the actual biological processes by which it develops are still being investigated. In essence though, pleural mesothelioma develops when jagged asbestos fibers are inhaled and settle in and around the lungs. The fibers become lodged in its small passageways and in the surface of its lining. The body’s immune system is able to process and breakdown some of these asbestos fibers, but invariably many still remain. Over time, the fibers cause chronic inflammation, the development of pleural fibroses (a thickening of the pleural surfaces) and pleural effusions (buildup of fluid in the pleural spaces) and in many people, cancerous cell development. If the fibers create a malignancy in the lung itself, one is diagnosed with lung cancer. If the malignancy begins in one of the pleural tissues, one is diagnosed with pleural mesothelioma.

当科学最终表明石棉暴露是引起间皮瘤的唯一因素,它是如何发展的实际生物进程仍在研究。本质上,当石棉纤维被吸入并在肺内或周围持续存在使得胸膜间皮瘤发展。纤维在肺的小通道里定居和覆盖于它的表面。机体的免疫系统可以处理和分解一部分石棉纤维,但是常常大部分还是存留下来。随着时间的推移,这些纤维导致慢性炎症,使得胸膜纤维化(胸膜表面增厚)和胸膜腔积液(胸膜腔内液体的增加),并在大部分人中,癌细胞开始生长。如果这些纤维导致肺本身的恶性病变,诊为肺癌。如果恶性病变开始于胸膜组织,诊为胸膜间皮瘤。

It is because of the proximity of the pleurae to the lung that many people mistakenly think of pleural mesothelioma as a form of lung cancer. While a pleural malignancy can invade the lung, the tumor’s origin site is still the pleura, so pleural mesothelioma should never be treated as lung cancer.

因为胸膜接近于肺,大多数人误认为胸膜间皮瘤是肺癌的一种形式。当胸膜的恶性病变侵及肺,肿瘤的原发灶仍是胸膜,因此胸膜间皮瘤是不能被当成肺癌治疗。

To learn more about the differences between mesothelioma and lung cancer, please read: mesothelioma and lung cancer.

想了解更多间皮瘤和肺癌的差别请读阅:间皮瘤和肺癌

Mesothelioma and Lung Cancer间皮瘤和肺癌

 

As pleural mesothelioma is the most common form of mesothelioma, mesothelioma is often considered or spoken of as a form of lung cancer, but this is incorrect. Mesothelioma and lung cancer are completely different diseases, with different origin sites, tumor structure and treatability.

由于胸膜间皮瘤是间皮瘤最常见的形式,间皮瘤常被认为或说成肺癌的一种形式,但这是不对的。间皮瘤和肺癌是两个在起源、肿瘤构成和治疗等完全不同的疾病。

Mesothelioma is a cancer that affects the mesothelium, which are the serous membranes that protect and support different organs in the body by secreting fluid that reduces friction and eases movement of those organs within their respective body cavities. In its most common form, pleural mesothelioma, mesothelioma affects the pleural surfaces in the chest cavity. The parietal pleura lines the inner chest wall and the visceral pleura encases the lungs. The fluids secreted by each pleura enable the lungs to move easily when breathing. Pleural mesothelioma can spread to the lungs and invade its inner tissues, but the origin site of the cancer remains the pleura.

间皮瘤是影响间皮的一种癌症。间皮是可以保护和支持机体不同的器官通过分泌液体减少这些器官在他们各自腔隙的摩擦和缓冲运动的浆膜。在它最常见的形式,胸膜间皮瘤,间皮瘤影响胸腔胸膜的表面。壁层胸膜在胸壁内部,脏层胸膜包裹肺脏。胸膜分泌的液体使得肺可以在呼吸时流畅运动。胸膜间皮瘤可以传播至肺部并侵及它内在组织,但是癌症起源仍是胸膜。

The other major form of mesothelioma, peritoneal mesothelioma, which affects mesothelial tissue in the peritoneum, can also spread to the lungs, but its origin site remains either the parietal or visceral peritoneum.

胸膜间皮瘤的另一个主要形式,腹膜间皮瘤,影响腹膜的间皮组织,亦可转移至肺脏,但是它的起源仍是壁层或脏层腹膜。

Cancer Guidelines 癌症指南

Cancer guidelines teach that a tumor which invades another surface is still a form of the original cancer and generally retains its overall structure and behavior. It is because of these guidelines that we speak of mesothelioma as distinct from lung cancer.

癌症指南告诉我们癌症侵及另一表面仍是起源的癌症的一种形式,并且一半还保持它总的结构和行为,正因为这些指南我们说间皮瘤不同于肺癌。

Differences Between Mesothelioma and Lung Cancer 间皮瘤和肺癌的区别

Mesothelioma is a diffuse malignancy. It invades a tissue area as a large number of interlocked tumors and the boundaries between malignant tissue and healthy tissue are blurred and, eventually, dissolved. This is the primary reason that mesothelioma remains so difficult to treat. The large extent of malignant tissue makes complete surgical resection very difficult. Chemotherapy is generally unable to inhibit the growth of so many masses, nor is radiation effective over such large areas. In its late stages, mesothelioma engulfs the invaded tissues, wrapping completely around it and restricting its ability to move.

间皮瘤是一个播散性的恶性病变。它侵及组织区为大量交错的肿瘤,恶性组织和正常组织的界限模糊,最终消失。这是间皮瘤仍是难以治疗的起始原因。恶性组织的大规模延伸使得手术切除变得困难。化疗一般也不足以抑制如此多肿块的生长,放疗也不能有效地覆盖如此大的区域。在它的晚期,间皮瘤弥漫受侵组织,完全的紧紧包裹它并限制它的运动。

Lung cancer works differently. It arises within the lungs themselves and is characterized by individualized tumor masses. Even for people with multiple masses, the tumors generally possess clear boundaries. The tumors can grow quite large and in its late stages and most aggressive forms, lung cancer is just as deadly as mesothelioma. However, it is much more amenable to treatment than mesothelioma is. Because of the individualized natures of its tumors, it is possible to completely remove all visible malignant tissue. Chemotherapy and radiation are more effective treatment modalities as well. None of this is to say that lung cancer is not a serious diagnosis, because it is a deadly serious disease. It is simply to draw a clear difference between lung cancer and mesothelioma.

肺癌不同。它发生在肺部和具有个性化的肿块。即使多发肿块,肿瘤一般也有清晰的边界。肿瘤在晚期可以很大并最具侵袭性的形式,肺癌可以像间皮瘤一样是致命性的。然而,它对治疗比间皮瘤敏感。因为肿瘤的个性化性质,它可以完全移除可见的肿瘤组织。化疗和放疗也是更有效的治疗形式。这并不是说肺癌不是严重的诊断,因为它是一个极其严重的疾病。这简单的表明肺癌和间皮瘤的区别。

There are other differences between lung cancer and mesothelioma as well. While asbestos exposure is a causative factor for both disorders, it is the only known cause of mesothelioma while lung cancer can be caused by other agents—including cigarette smoking.

同时肺癌和间皮瘤有其它的区别。尽管石棉暴露是两个紊乱的病因因素,它是间皮瘤的仅有的知道的原因而肺癌也可被其它媒介包括吸烟引起。

Another difference between mesothelioma and lung cancer involves the incidence rates between the two diseases. Mesothelioma is a rare disorder, affecting about three thousand people per year, while lung cancer has a diagnostic rate 65 times greater than mesothelioma with nearly 200,000 yearly diagnoses. As people stop smoking, lung cancer incidence is expected to drop but oncologists still expect decades of tobacco-related lung cancers.

另一个间皮瘤和肺癌的区别和发病率有关。间皮瘤罕见,每年影响大约三千人,而每年诊为肺癌的接近于200,000人,是间皮瘤诊断率的65倍。随着人们的戒烟,肺癌的发病率有望下降,但是肿瘤学家仍预测数十年的香烟相关肺癌。

Mesothelioma and lung cancer are very different diseases. While the most common form of mesothelioma begins in tissue very close to the lung, the very real differences in tumor structure and malignant behavior clearly identify the individual differences between these forms of cancer.

间皮瘤和肺癌是非常不同的疾病。尽管间皮瘤最常见的形式发生于接近肺的组织,在肿瘤结构和恶性行为很真实的不同清晰地辨别了这些形式癌症的个体差异。

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