Mesothelioma: Brochard P

Brochard P. · No affiliation provided · Rev Pneumol Clin. · Pubmed #18166940 No free full text.

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Ameille J, Brochard P, Letourneux M, Paris C, Pairon JC. · Unité de pathologie professionnelle, AP-HP, Hôpital Raymond-Poincaré, Garches, France. · Rev Mal Respir. · Pubmed #19421094 No free full text.

Abstract: INTRODUCTION: The relationships between benign asbestos-related diseases (asbestosis and pleural plaques) and thoracic cancers are still debated. The aim of this paper is to analyse epidemiological data which investigate this topic. STATE OF THE ART: Published studies show that there is a significant relationship between occupational exposure to asbestos and lung cancer risk, even in the absence of abnormalities consistent with asbestos exposure on postero-anterior chest x-ray. In subjects with occupational exposure to asbestos, an increased risk of lung cancer and pleural mesothelioma is observed in subjects with pleural plaques on chest x-ray, in comparison with the general population. In exposed subjects with similar cumulative exposure to asbestos, it is not demonstrated that pleural plaques are associated with an increased risk of lung cancer or pleural mesothelioma. PERSPECTIVES: All the analysed studies are only based on radiographic data. Their results must be confirmed by additional studies including a rigorous evaluation of the cumulative exposure to asbestos and chest CT-scans. CONCLUSION: In the present state of knowledge, isolated pleural plaques do not justify specific medical surveillance, as compared to that required by the mere estimated cumulative exposure to asbestos.

Galateau-Sallé F, Attanoos R, Gibbs AR, Burke L, Astoul P, Rolland P, Ilg AG, Pairon JC, Brochard P, Begueret H, Vignaud JM, Kerr K, Launoy G, Imbernon E, Goldberg M. · Mesopath Group, ERI 3 Inserm, CHU Caen, Caen, France. · Am J Surg Pathol. · Pubmed #17460454 No free full text.

Abstract: The lymphohistiocytoid variant of diffuse malignant mesothelioma is rare with very few cases described in the literature. It is characterized by mesothelial cells with a histiocytelike appearance and an associated dense lymphoid infiltrate. We studied clinicopathologic features and immunohistochemical patterns of a series of 22 cases. The histiocytelike cells had a mesothelial immunophenotype: AE1/AE3 (100%), calretinin (100%), CK5/6 (46%), and EMA (52%). The prominent lymphoid component showed a cytotoxic T-cell immunophenotype. Prognosis was similar to that of a large series of epithelioid diffuse malignant mesotheliomas. Formely, it was classified within the sarcomatoid type. We suggest that it should be reclassified as an epithelioid variant because of its similar behavioural characteristics. There was no evidence of Epstein-Barr virus-related infection.

Pairon JC, Fournier M, Astoul P, Galateau-Sallé F, Brochard P. · Service de pneumologie et pathologie professionnelle, CHI Créteil, et INSERM E03-37, Faculté de Médecine, Créteil, France. · Rev Mal Respir. · Pubmed #17370386 No free full text.

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Galateau-Sallé F, Copin MC, Delajartre AY, Vignaud JM, Astoul P, Pairon JC, Le Pimpec-Barthes F, Brochard P. · Groupe Mesopath, CHU Caen. · Rev Mal Respir. · Pubmed #17370378 No free full text.

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Pairon JC, Jaurand MC, Laurent F, Salmi R, Astoul P, Galateau-Sallé F, Brochard P. · Service de pneumologie et pathologie professionnelle, CHI Créteil, et INSERM E03-37, Faculté de médecine, Créteil, France. · Rev Mal Respir. · Pubmed #17370376 No free full text.

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Vandentorren S, Salmi LR, Mathoulin-Pélissier S, Baldi I, Brochard P, Anonymous00275. · Laboratoire Santé Travail Environnement (EA 3672, IFR-99 Santé Publique), Université Victor Segalen Bordeaux 2, Bordeaux, France. · Scand J Work Environ Health. · Pubmed #16539170 No free full text.

Abstract: OBJECTIVES: Many potential occupational causes of cancer have been documented. Imputation of an individual cancer to occupational or other causes is, however, difficult. A method based on the Bayes theorem is proposed for assessing causal relationships at the individual level. METHODS: Causality assessment, dealing with four types of persons defined by exposure and the occurrence of cancer, was linked with imputation, only dealing with persons who have cancer and were exposed. Imputation was then formulated using the Bayes theorem, relating epidemiologic information regarding causes, a patient's exposure history, and the posterior odds that the cancer was caused by a suspected occupational exposure. Data needed to apply a Bayesian method were defined in terms of relative risks, proportion of people exposed in populations, and the frequency of a positive relevant characteristic for persons without cancer. A relevant characteristic was defined using a formal consensus between experts. The method was then illustrated with cases of mesothelioma and lung cancer in possible relation to asbestos. RESULTS: Experts defined the relevant characteristics as being qualification of occupational exposure, intensity of exposure, latency, disease characteristics, and presence of causal agent in the body. Application to mesothelioma and lung cancer cases illustrated the potential usefulness of the method. CONCLUSIONS: The importance of occupational exposure in the formulation of imputation underscores the need for available and reliable data sources on occupational exposures. The proposed method could become a powerful tool for the expert assessment of causes of cancer cases, provided data become available in individual files and the literature.

Goldberg M, Imbernon E, Rolland P, Gilg Soit Ilg A, Savès M, de Quillacq A, Frenay C, Chamming's S, Arveux P, Boutin C, Launoy G, Pairon JC, Astoul P, Galateau-Sallé F, Brochard P. · Département Santé Travail, Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94410 Saint Maurice, France. · Occup Environ Med. · Pubmed #16469823 links to  free full text

Abstract: OBJECTIVES: The French National Mesothelioma Surveillance Program (NMSP) was established in 1998 by the National Institute for Health Surveillance (InVS). Its objectives are to estimate the trends in mesothelioma incidence and the proportion attributable to occupational asbestos exposure, to help improve its pathology diagnosis, to assess its compensation as an occupational disease, and to contribute to research. METHODS: The NMSP records incident pleural tumours in 21 French districts that cover a population of approximately 16 million people (a quarter of the French population). A standardised procedure of pathological and clinical diagnosis ascertainment is used. Lifetime exposure to asbestos and to other factors (man made mineral fibres, ionising radiation, SV40 virus) is reconstructed, and a case-control study was also conducted. The proportion of mesothelioma compensated as an occupational disease was assessed. RESULTS: Depending on the hypothesis, the estimated number of incident cases in 1998 ranged from 660 to 761 (women: 127 to 146; men: 533 to 615). Among men, the industries with the highest risks of mesothelioma are construction and ship repair, asbestos industry, and manufacture of metal construction materials; the occupations at highest risk are plumbers, pipe-fitters, and sheet-metal workers. The attributable risk fraction for occupational asbestos exposure in men was 83.2% (95% CI 76.8 to 89.6). The initial pathologist's diagnosis was confirmed in 67% of cases, ruled out in 13%, and left uncertain in the others; for half of the latter, the clinical findings supported a mesothelioma diagnosis. In all, 62% applied for designation of an occupational disease, and 91% of these were receiving workers' compensation. CONCLUSIONS: The NMSP is a large scale epidemiological surveillance system with several original aspects, providing important information to improve the knowledge of malignant pleural mesothelioma, such as monitoring the evolution of its incidence, of high risk occupations and economic sectors, and improving pathology techniques.

Iwatsubo Y, Matrat M, Michel E, Boutin C, Galateau-Salle F, Jougla E, Bignon J, Pairon JC, Brochard P. · INSERM E99-09, Créteil, France. · Am J Ind Med. · Pubmed #12210688 No free full text.

Abstract: BACKGROUND: The number of cases of pleural mesothelioma in France has varied substantially according to methods of assessment. MATERIALS AND METHODS: We collected information from certifying physicians about 316 subjects who died between 1 July 1992 and 30 June 1993 in three regions of France with a cause of death coded as ICD-9 category 163. The ICD codes selected as the cause of death for 178 deaths between 1 January 1987 and 31 December 1992 histologically confirmed and diagnosed as pleural mesothelioma by an expert committee were examined. Finally, we used this information to estimate the number of deaths from pleural mesothelioma in France in 1992. RESULTS: In Part I, 45% (men: 54%; women: 28%) of the cases coded as ICD-9 section 163 were definitely or probably mesothelioma; 18% (men: 16%; women: 21%) possibly mesothelioma; and 37% (men: 30%; women: 51%) other tumors, primarily adenocarcinoma metastases. In Part II, 74% of the confirmed pleural mesotheliomas were coded in category 163 (men: 75%; women: 70%). Extrapolation nationwide indicated that 902 deaths were coded as ICD-9 163 in 1992: 521 cases involved definite or probable mesothelioma and 724 definite, probable, and possible cases. CONCLUSIONS: The analysis of this sample suggests that estimating the number of mesothelioma cases from the cause-of-death statistics may overestimate their incidence, but that death certificates appeared to report the diagnosis of histologically confirmed mesothelioma accurately.

Luce D, Bugel I, Goldberg P, Goldberg M, Salomon C, Billon-Galland MA, Nicolau J, Quénel P, Fevotte J, Brochard P. · Institut National de la Santé et de la Recherche Médicale Saint-Maurice, France. · Am J Epidemiol. · Pubmed #10670550 links to  free full text

Abstract: A case-control study on respiratory cancers was conducted in New Caledonia (South Pacific), where a high incidence of malignant pleural mesothelioma had been observed. The disease pattern suggested an environmental exposure to asbestos. The first results showed that, in some areas, tremolite asbestos derived from local outcroppings was used as whitewash (locally named "pö"). All cases diagnosed between 1993 and 1995 (including 15 pleural mesotheliomas, 228 lung cancers, and 23 laryngeal cancers) and 305 controls were included in the study. Detailed information on past or present use of the whitewash, residential history, smoking, diet, and occupation was collected. The risk of mesothelioma was strongly associated with the use of the whitewash (odds ratio (OR) = 40.9; 95% confidence interval (CI): 5.15, 325). All Melanesian cases had been exposed. Among Melanesian women, exposure to the whitewash was associated with an increased risk of lung cancer (OR = 4.89; 95% CI: 1.13, 21.2), and smokers exposed to po had an approximately ninefold risk (OR = 9.26; 95% CI: 1.72, 49.7) compared with women who never smoked and had never used the whitewash. In contrast, no association was noted between exposure to pö and lung cancer risk among Melanesian men, probably because of lower exposure levels. Among non-Melanesians, the numbers of exposed subjects were too small to assess the effect of exposure to po. There was no indication of elevated risks for the other cancer sites.