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恶性间皮瘤肿瘤:分子发病机制、诊断及伴随临床研究的治疗方法

Malignant mesothelioma tumours: molecular pathogenesis, diagnosis, and therapies accompanying clinical studies.

作者信息

Sahu Ram Kumar, Ruhi Sakina, Jeppu Ashok Kumar, Al-Goshae Husni Ahmed, Syed Ayesha, Nagdev Sanjay, Widyowati Retno, Ekasari Wiwied, Khan Jiyauddin, Bhattacharjee Bedanta, Goyal Manoj, Bhattacharya Sankha, Jangde Rajendra K

机构信息

Department of Pharmaceutical Sciences, Hemvati Nandan Bahuguna Garhwal University (A Central University), Chauras, Tehri Garhwal, Uttarakhand, India.

Department of Biochemistry, International Medical School (IMS), Management and Science University, Shah Alam, Selangor, Malaysia.

出版信息

Front Oncol. 2023 Jul 4;13:1204722. doi: 10.3389/fonc.2023.1204722. eCollection 2023.

Abstract

The pathetic malignant mesothelioma (MM) is a extremely uncommon and confrontational tumor that evolves in the mesothelium layer of the pleural cavities (inner lining- visceral pleura and outer lining- parietal pleura), peritoneum, pericardium, and tunica vaginalis and is highly resistant to standard treatments. In mesothelioma, the predominant pattern of lesions is a loss of genes that limit tumour growth. Despite the worldwide ban on the manufacture and supply of asbestos, the prevalence of mesothelioma continues to increase. Mesothelioma presents and behaves in a variety of ways, making diagnosis challenging. Most treatments available today for MM are ineffective, and the median life expectancy is between 10 and 12 months. However, in recent years, considerable progress has already been made in understanding the genetics and molecular pathophysiology of mesothelioma by addressing hippo signaling pathway. The development and progression of MM are related to many important genetic alterations. This is related to NF2 and/or LATS2 mutations that activate the transcriptional coactivator YAP. The X-rays, CT scans, MRIs, and PET scans are used to diagnose the MM. The MM are treated with surgery, chemotherapy, first-line combination chemotherapy, second-line treatment, radiation therapy, adoptive T-cell treatment, targeted therapy, and cancer vaccines. Recent clinical trials investigating the function of surgery have led to the development of innovative approaches to the treatment of associated pleural effusions as well as the introduction of targeted medications. An interdisciplinary collaborative approach is needed for the effective care of persons who have mesothelioma because of the rising intricacy of mesothelioma treatment. This article highlights the key findings in the molecular pathogenesis of mesothelioma, diagnosis with special emphasis on the management of mesothelioma.

摘要

恶性间皮瘤(MM)是一种极为罕见且难以对付的肿瘤,它发生于胸膜腔(内层——脏层胸膜和外层——壁层胸膜)、腹膜、心包膜及鞘膜的间皮层,并且对标准治疗具有高度抗性。在间皮瘤中,主要的病变模式是限制肿瘤生长的基因缺失。尽管全球已禁止生产和供应石棉,但间皮瘤的患病率仍在持续上升。间皮瘤的表现形式多样,这使得诊断颇具挑战性。目前大多数针对MM的治疗方法效果不佳,中位预期寿命在10至12个月之间。然而,近年来,通过研究河马信号通路,在理解间皮瘤的遗传学和分子病理生理学方面已经取得了相当大的进展。MM的发生和发展与许多重要的基因改变有关。这与激活转录共激活因子YAP的NF2和/或LATS2突变有关。X射线、CT扫描、MRI和PET扫描用于诊断MM。MM的治疗方法包括手术、化疗、一线联合化疗、二线治疗、放射治疗、过继性T细胞治疗、靶向治疗和癌症疫苗。最近关于手术功能的临床试验带来了治疗相关胸腔积液的创新方法以及靶向药物的引入。由于间皮瘤治疗的复杂性不断增加,对患有间皮瘤的患者进行有效护理需要采用跨学科协作方法。本文重点介绍了间皮瘤分子发病机制的关键发现,特别强调了间皮瘤的诊断及治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2463/10353315/15a7680fc36d/fonc-13-1204722-g001.jpg

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