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Lung carcinoma and malignant mesothelioma in patients exposed to thorotrast: Incidence, histology and p53 status
Author(s) -
Andersson Michael,
Wallin Håkan,
Jönsson Marzieh,
Nielsen Lise L.,
Visfeldt Jakob,
Vyberg Mogens,
Bennett William P.,
De Benedetti Virna M. G.,
Travis Lois B.,
Storm Hans H.
Publication year - 1995
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.2910630304
Subject(s) - thorotrast , medicine , mesothelioma , adenocarcinoma , lung cancer , pathology , carcinoma , lung , adenocarcinoma of the lung , cancer
In a previous registry‐based survey of 999 patients injected with α‐emitting 232 ThO 2 (Thorotrast), we identified elevated risks for lung carcinoma and malignant mesothelioma. Since injected Thorotrast is retained lifelong mostly in liver, spleen and lymph nodes, the mesothelial surfaces of these organs are constantly irradiated. Thorotrast‐administered patients also perpetually exhale 220 Rn, a 232 Th‐daughter. Study of Thorotrast‐exposed patients may, therefore, provide data with regard to carcinogenicity of radon exposure, a current public health concern, as well as the pathogenesis of malignant mesothelioma. The incidence and histologic types of lung carcinoma and malignant mesothelioma within the cohort were examined by review of available histopathologic material and medical records. Further, mutations of the p53 gene were analyzed whenever possible as it has previously been suggested that radon‐associated lung carcinomas exhibit specific mutational patterns. The cumulative risk for lung carcinoma reached 11.0% based on 20 confirmed cases. Nine were small cell lung cancer (SCLC), whereas the expected frequency was 18%. The risk for malignant mesothelioma reached 2.5% based on 7 cases. The actuarial risk of malignant mesothelioma for patients given more than 20 ml Thorotrast was 7.8% compared to 1.4% for patients administered smaller amounts. Seven lung carcinomas and 5 malignant mesotheliomas were analyzed for p53 mutations; only 1 (in a lung adenocarcinoma) was detected. A possible association between Thorotrast and SCLC is suggested. In addition, a possible dose‐response gradient exists for Thorotrast and malignant mesothelioma.