马思源 杨虹 高小卓 石玲玲 李晓波 黄波

所有作者声明不存在利益冲突，马思源，杨虹，高小卓，石玲玲，李晓波五位作者均为共同第一作者

*通信作者：黄波，1970年3月，女，汉族，辽宁沈阳人，现任中国医科大学肿瘤医院、辽宁省肿瘤医院副主任，硕士研究生导师，主任医师，博士研究生（博士后）。研究方向：肿瘤的侵袭与转移的研究。

基金项目：本课题受国家癌症中心攀登基金资助（基金编号：NCC201806B008）。

摘要：间皮瘤的发病率虽然远低于相同部位的癌，但因其30～40年的超长潜伏期，很难早期发现诊断，并且与相应部位的恶性肿瘤难以区分，缺乏有效的治疗手段使恶性间皮瘤成为生存期短、死亡率极高的高度恶性肿瘤。近年来随着新发病例逐渐增多，有预测世界范围内将面临爆发的风险。与间皮瘤相关的危险因素包括硅酸盐矿物、猿猴病毒40（SV40）、慢性炎症等，已经明确，但机制性研究延迟于相应部位癌的进展，真实世界中尚缺乏特异性的诊断和靶向治疗指标，导致晚期间皮瘤患者较多且预后较差。本文将从流行病学角度对间皮瘤的危险因素及其機制、流行病学一般特征等加以综述，提高对间皮瘤的发病认识，为进一步寻求间皮瘤的预防、诊断、治疗的措施提供科学依据。

关键词：间皮瘤;危险因素;流行病学;潜伏期

Abstract： Although the incidence rate of mesothelioma is far below that of cancers at the same location， it is hard to detect and diagnosis at the early stage and it is difficult to distinguish from malignant tumor in the corresponding parts due to its extremely long incubation period of 30-40 years. The lack of effective treatment makes malignant mesothelioma a highly malignant tumor with short survival time and high mortality. In recent years， it is predicted that the world will face the risk of outbreak with the gradual increase of new cases. The risk factors associated with mesothelioma include silicate minerals， simian virus 40 （SV40）， chronic inflammation， etc. It has been clarified. However， the mechanism research is delayed in the progress of cancer at the corresponding site and there is still a lack of specific diagnosis and targeted treatment indicators in the real world， resulting in more patients with advanced mesothelioma and poor prognosis. This paper reviews the risk factors， mechanism and general epidemiological characteristics of mesothelioma from the perspective of epidemiology， so as to improve the understanding of the pathogenesis of mesothelioma and provide scientific basis for further seeking the measures of prevention， diagnosis and treatment of mesothelioma.

Keywords： Mesothelioma; Risk factors; Epidemiology; Incubation period

一、前言

间皮瘤是来源于间皮细胞的肿瘤，间皮细胞分布广泛，被覆在胸膜、腹膜以及心包膜的脏层和壁层表面，导致间皮瘤也具有广泛分布的特点，胸膜间皮瘤发病率达65%～70%、腹膜间皮瘤为30%，心包膜间皮瘤仅为1%～2%，睾丸鞘膜、输卵管浆膜及女性生殖道发病更少[1，2]。……