| Malignant mesothelioma (MM)is a tumor with a high invasiveness and a grim prognosis. Tumor's biologic features are a reaction of particularity of parenchyma and mesechyma of tumor .In this article , we studied the prognostic factors of MM through the methods of clinical-pathological analysis, immunohistochemistry and molecular biology. We aim to know the relation of several factors in order to judge the factors effecting the natural processes of MM and to provide more theoretical basis for its gene therapy.1 Clinical Data We screened 99 cases of MM having follow-up survey to carry out clinical-pathological analysis. The cases were diagnosed at the department of pathology from 1980 to 1999 years. The peak incidence of MM was at the age of 40-50 years with the male to female ratio of 1.65:1. The predilection sites are the pleura and peritoneum. According to histological structure these cases were divided into: epithelioid type are 53 cases (52%), mixed type are 27 (26%) and sarcomatous type are 19 cases (22%) .The survival time of 99 cases was between 5 and 160 months (the medial survival 23 months), the 2 years survival rate was 36 percent and the 5 years survival rate was 1 lpercent. The Cox-regression analysis showed sex, location and clinical situation were not correlated with the prognosis of MM, but, age, clinical-pathological stage histological subtype were correlated with prognosis. According to clinical experience we also made the comparisons of prognosis between the cystic mesothelioma of low grade malignant and others type, between localized and diffused MM. The results showed the prognosis of cystic mesothelioma was better than other type (P<0.01), localized mesothelioma had a better trend than diffused (P=0.14).2 Intratumoral Microvascular Densicy (IMD) According to the IMDthe patients of MM were divided into two groups . The survival time of thegrouP with higher IMD was significanly shorter than the lower grouP. We alscanalyzed the relation of VEGF expression to IDM, survival time an'histological subtype. The result showed that VEGF expression was positivel}correlated to IMD (P=0.0188,r=0.33 ) .There was a significan differenccbetween the survival of VEGF positive expression and negative exPression,P <0.05, but was not a difference among the histological subtyPe(P>0.05).3 ProIiferation and Apoptosis Index of Tumor cell The significamdifference of the survival time was found between the grouP with higher Ki-67expression and the lowers. The survival time of the grouP with higheIaPoptotic index was significamly shorter than the lowers. (r=0.545,P<0.01 ).In the article,we also comPared the correlation between the aPoptotic indexand Ki-67 expression and fOund a significan correlation through correlativeanalysis (r=0.545,P<0.01 ) .In addition,the aPoptotic index with bcl-2negative expression was significantly higher (AI=1.02) than bcl-2 positiveexpression(AI=0.32), P=0.012,. The results showed that bcl-2 eXPression havean association with the aPoptotic index. HoweveY, the aPoptotic index did notsignificanly associate with bax expression P=0.46. Both bcl-2 and baxexpression had not significanly effect to the survival of malignantmesothelioma, P=0.43,P=0.26 respectively.4. SimianVirus 40 SV40 can be detected in the tissue of malignammesothelioma with polymerase chain reaction method. SV40-negative patientshad a trend for increased survival time. We also analyzed the relation betweenhistology subtyPe and SV40 expression. The results showed that SV40expression was significanly related with mixed and sarcomatoid twe(chi-square=5.0l, P=0.023 ).
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