肺癌早期诊断的研究进展
Research Progress in Early Diagnosis of Lung Cancer
DOI: 10.12677/acm.2024.1441308, PDF,   
作者: 刘耘沁, 李升锦*：重庆医科大学附属第二医院呼吸与危重症医学科，重庆
关键词: 肺癌；早期诊断；低剂量螺旋CT；支气管镜检查；液体活检；Lung Cancer； Early Stage Diagnosis； Low-Dose CT； Bronchoscopy； Liquid Biopsy
摘要: 在全球范围内肺癌是最常见的癌症，在我国，肺癌则是发病率及死亡率最高的恶性肿瘤，对社会造成了极大的负担。早期肺癌多无明显临床症状及体征，多数肺癌患者出现症状首次就诊时已为晚期，晚期肺癌5年生存率极低，因此探索有效的肺癌早期诊断及诊断方法，对于改善肺癌患者的生存预后有重要意义。目前在我国，低剂量螺旋CT检查是肺癌早期诊断的常见方法，显著提高了早期肺癌诊断率。支气管镜检查作为目前肺癌诊断的常用方法也有着较高的敏感性及特异性。液体活检因其可通过非侵入性方法获取患者组织标本、可实时监测肿瘤动态变化等优点，是目前临床最有前途的肿瘤组织活体检查的替代手段。本文就肺癌早期诊断方法的相关研究进展进行综述。
Abstract: Lung cancer is the most common cancer globally, and in China, it is the malignant tumor with the highest morbidity and mortality rate, causing a great burden to the society. Early stage lung cancer has no obvious clinical symptoms and signs, and most of the lung cancer patients are already in advanced stage when they first visit the doctor with symptoms. The 5-year survival rate of advanced lung cancer is extremely low. Exploring effective early screening and diagnostic methods for lung cancer is of great significance to improve the survival and prognosis of lung cancer patients. At present, low-dose CT examination is a common method for early diagnosis of lung cancer in China, which has significantly improved the diagnosis rate of early lung cancer. Bronchoscopy, as a common method for lung cancer diagnosis, also has high sensitivity and specificity. Liquid biopsy is the most promising clinical alternative to tumor tissue biopsy due to its advantages of obtaining tissue specimens from patients through non-invasive methods and real-time monitoring of tumor dynamic changes. This article reviews the progress of research related to early diagnostic methods for lung cancer.
文章引用：刘耘沁, 李升锦. 肺癌早期诊断的研究进展[J]. 临床医学进展, 2024, 14(4): 2406-2413. https://doi.org/10.12677/acm.2024.1441308

参考文献

[1] Siegel, R.L., Miller, K.D., Fuchs, H.E., et al. (2022) Cancer Statistics, 2022. CA: A Cancer Journal for Clinicians, 72, 7-33. [Google Scholar] [CrossRef] [PubMed]
[2] Han, B., Zheng, R., Zeng, H., et al. (2024) Cancer Incidence and Mortality in China, 2022. Journal of the National Cancer Center, 4, 47-53. [Google Scholar] [CrossRef] [PubMed]
[3] Mattiuzzi, C. and Lippi, G. (2019) Current Cancer Epidemiology. Journal of Epidemiology and Global Health, 9, 217-222. [Google Scholar] [CrossRef] [PubMed]
[4] Akin, O., Brennan, S.B., Dershaw, D.D., et al. (2012) Advances in Oncologic Imaging: Update on 5 Common Cancers. CA: A Cancer Journal for Clinicians, 62, 364-393. [Google Scholar] [CrossRef] [PubMed]
[5] Frost, J.K., Ball, W.C., et al. (1984) Early Lung Cancer Detection: Results of the Initial (Prevalence) Radiologic and Cytologic Screening in the Johns Hopkins Study. American Review of Respiratory Disease, 130, 549-554.
[6] Van Der Aalst, C.M., Ten Haaf, K. and De Koning, H.J. (2016) Lung Cancer Screening: Latest Developments and Unanswered Questions. The Lancet Respiratory Medicine, 4, 749-761. [Google Scholar] [CrossRef] 
[7] Kubík, A. and Polák, J. (1986) Lung Cancer Detection Results of a Randomized Prospective Study in Czechoslovakia. Cancer, 57, 2427-2437. [Google Scholar] [CrossRef] 
[8] Bradley, S.H., Abraham, S., Callister, M.E., et al. (2019) Sensitivity of Chest X-Ray for Detecting Lung Cancer in People Presenting with Symptoms: A Systematic Review. British Journal of General Practice, 69, E827-E835. [Google Scholar] [CrossRef] 
[9] The National Lung Screening Trial Research Team (2011) Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. New England Journal of Medicine, 365, 395-409. [Google Scholar] [CrossRef] 
[10] Brenner, D.J. (2004) Radiation Risks Potentially Associated with Low-Dose CT Screening of Adult Smokers for Lung Cancer. Radiology, 231, 440-445. [Google Scholar] [CrossRef] [PubMed]
[11] Ohno, Y. (2014) New Applications of Magnetic Resonance Imaging for Thoracic Oncology. Seminars in Respiratory and Critical Care Medicine, 35, 27-40. [Google Scholar] [CrossRef] [PubMed]
[12] Sommer, G., Tremper, J., Koenigkam-Santos, M., et al. (2014) Lung Nodule Detection in a High-Risk Population: Comparison of Magnetic Resonance Imaging and Low-Dose Computed Tomography. European Journal of Radiology, 83, 600-605. [Google Scholar] [CrossRef] [PubMed]
[13] Wang, Y.X, J., Lo, G.G., Yuan, J., et al. (2014) Magnetic Resonance Imaging for Lung Cancer Screen. Journal of Thoracic Disease, 6, 1340-1348.
[14] Lam, S., Macaulay, C., Hung, J., et al. (1993) Detection of Dysplasia and Carcinoma in Situ with a Lung Imaging Fluorescence Endoscope Device. The Journal of Thoracic and Cardiovascular Surgery, 105, 1035-1040. [Google Scholar] [CrossRef] 
[15] Escarguel, B., D’Amore, D., Chapel, F., et al. (2009) [Early Diagnosis of Lung Cancer: Impact of Autofluorescence Bronchoscopy]. Revue De Pneumologie Clinique, 65, 287-291. [Google Scholar] [CrossRef] [PubMed]
[16] Moghissi, K., Dixon, K. and Stringer, M.R. (2008) Current Indications and Future Perspective of Fluorescence Bronchoscopy: A Review Study. Photodiagnosis and Photodynamic Therapy, 5, 238-246. [Google Scholar] [CrossRef] [PubMed]
[17] Gu, P., Zhao, Y.Z., Jiang, L.Y., et al. (2009) Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Staging of Lung Cancer: A Systematic Review and Meta-Analysis. European Journal of Cancer, 45, 1389-1396. [Google Scholar] [CrossRef] [PubMed]
[18] Navani, N., Nankivell, M., Lawrence, D.R., et al. (2015) Lung Cancer Diagnosis and Staging with Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Compared with Conventional Approaches: An Open-Label, Pragmatic, Randomised Controlled Trial. The Lancet Respiratory Medicine, 3, 282-289. [Google Scholar] [CrossRef] 
[19] Fu, C., Liu, Z., Zhu, F., et al. (2016) A Meta-Analysis: Is Low-Dose Computed Tomography a Superior Method for Risky Lung Cancers Screening Population? The Clinical Respiratory Journal, 10, 333-341. [Google Scholar] [CrossRef] [PubMed]
[20] Ost, D.E., Ernst, A., Lei, X., et al. (2016) Diagnostic Yield and Complications of Bronchoscopy for Peripheral Lung Lesions. Results of the AQuIRE Registry. American Journal of Respiratory and Critical Care Medicine, 193, 68-77. [Google Scholar] [CrossRef] 
[21] Rivera, M.P., Mehta, A.C. and Wahidi, M.M. (2013) Establishing the Diagnosis of Lung Cancer. Chest, 143, E142S-E165S. [Google Scholar] [CrossRef] [PubMed]
[22] Asano, F., Shinagawa, N., Ishida, T., et al. (2013) Virtual Bronchoscopic Navigation Combined with Ultrathin Bronchoscopy. A Randomized Clinical Trial. American Journal of Respiratory and Critical Care Medicine, 188, 327-333. [Google Scholar] [CrossRef] 
[23] Folch, E.E., Pritchett, M.A., Nead, M.A., et al. (2019) Electromagnetic Navigation Bronchoscopy for Peripheral Pulmonary Lesions: One-Year Results of the Prospective, Multicenter NAVIGATE Study. Journal of Thoracic Oncology, 14, 445-458. [Google Scholar] [CrossRef] [PubMed]
[24] Folch, E.E., Bowling, M.R., Pritchett, M.A., et al. (2022) NAVIGATE 24-Month Results: Electromagnetic Navigation Bronchoscopy for Pulmonary Lesions at 37 Centers in Europe and the United States. Journal of Thoracic Oncology, 17, 519-531. [Google Scholar] [CrossRef] [PubMed]
[25] Casal, R.F., Sarkiss, M., Jones, A.K., et al. (2018) Cone Beam Computed Tomography-Guided Thin/Ultrathin Bronchoscopy for Diagnosis of Peripheral Lung Nodules: A Prospective Pilot Study. Journal of Thoracic Disease, 10, 6950-6959. [Google Scholar] [CrossRef] [PubMed]
[26] Kawakita, N., Takizawa, H., Toba, H., et al. (2021) Cone-Beam Computed Tomography versus Computed Tomography-Guided Ultrathin Bronchoscopic Diagnosis for Peripheral Pulmonary Lesions: A Propensity Score-Matched Analysis. Respirology, 26, 477-484. [Google Scholar] [CrossRef] [PubMed]
[27] Fielding, D.I, K., Bashirzadeh, F., Son, J.H., et al. (2019) First Human Use of a New Robotic-Assisted Fiber Optic Sensing Navigation System for Small Peripheral Pulmonary Nodules. Respiration, 98, 142-150. [Google Scholar] [CrossRef] [PubMed]
[28] Chaffer, C.L. and Weinberg, R.A. (2011) A Perspective on Cancer Cell Metastasis. Science, 331, 1559-1564. [Google Scholar] [CrossRef] [PubMed]
[29] Lei, Y., Sun, N., Zhang, G., et al. (2020) Combined Detection of Aneuploid Circulating Tumor-Derived Endothelial Cells and Circulating Tumor Cells May Improve Diagnosis of Early Stage Non-Small-Cell Lung Cancer. Clinical and Translational Medicine, 10, e128. [Google Scholar] [CrossRef] [PubMed]
[30] Bünger, S., Zimmermann, M. and Habermann, J.K. (2015) Diversity of Assessing Circulating Tumor Cells (CTCs) Emphasizes Need for Standardization: A CTC Guide to Design and Report Trials. Cancer and Metastasis Reviews, 34, 527-545. [Google Scholar] [CrossRef] [PubMed]
[31] Lin, D., Shen, L., Luo, M., et al. (2021) Circulating Tumor Cells: Biology and Clinical Significance. Signal Transduction and Targeted Therapy, 6, Article No. 404. [Google Scholar] [CrossRef] [PubMed]
[32] Kumaki, Y., Olsen, S., Suenaga, M., et al. (2021) Comprehensive Genomic Profiling of Circulating Cell-Free DNA Distinguishes Focal MET Amplification from Aneuploidy in Diverse Advanced Cancers. Current Oncology, 28, 3717-3728. [Google Scholar] [CrossRef] [PubMed]
[33] Liang, W., Zhao, Y., Huang, W., et al. (2019) Non-Invasive Diagnosis of Early-Stage Lung Cancer Using High-Throughput Targeted DNA Methylation Sequencing of Circulating Tumor DNA (CtDNA). Theranostics, 9, 2056-2070. [Google Scholar] [CrossRef] [PubMed]
[34] The Tracerx Consortium, the Peace Consortium, Abbosh, C., et al. (2017) Phylogenetic CtDNA Analysis Depicts Early-Stage Lung Cancer Evolution. Nature, 545, 446-451. [Google Scholar] [CrossRef] [PubMed]
[35] Chabon, J.J., Hamilton, E.G., Kurtz, D.M., et al. (2020) Integrating Genomic Features for Non-Invasive Early Lung Cancer Detection. Nature, 580, 245-251. [Google Scholar] [CrossRef] [PubMed]
[36] Rabinowits, G., Gerçel-Taylor, C., Day, J.M., et al. (2009) Exosomal MicroRNA: A Diagnostic Marker for Lung Cancer. Clinical Lung Cancer, 10, 42-46. [Google Scholar] [CrossRef] 
[37] Jiang, C., Zhang, N., Hu, X., et al. (2021) Tumor-Associated Exosomes Promote Lung Cancer Metastasis through Multiple Mechanisms. Molecular Cancer, 20, Article No. 117. [Google Scholar] [CrossRef] [PubMed]
[38] Zhao, Z., Liu, J., Wang, C., et al. (2014) MicroRNA-25 Regulates Small Cell Lung Cancer Cell Development and Cell Cycle through Cyclin E2. International Journal of Clinical and Experimental Pathology, 7, 7726-7734.
[39] Cui, R., Meng, W., Sun, H.L., et al. (2015) MicroRNA-224 Promotes Tumor Progression in Nonsmall Cell Lung Cancer. Proceedings of the National Academy of Sciences of the United States of America, 112, E4288-E4297. https://pnas.org/doi/full/10.1073/pnas.1502068112 [Google Scholar] [CrossRef] [PubMed]
[40] Edmonds, M.D., Boyd, K.L., Moyo, T., et al. (2015) MicroRNA-31 Initiates Lung Tumorigenesis and Promotes Mutant KRAS-Driven Lung Cancer. Journal of Clinical Investigation, 126, 349-364. [Google Scholar] [CrossRef] 
[41] Janowska-Wieczorek, A., Wysoczynski, M., Kijowski, J., et al. (2005) Microvesicles Derived from Activated Platelets Induce Metastasis and Angiogenesis in Lung Cancer. International Journal of Cancer, 113, 752-760. [Google Scholar] [CrossRef] [PubMed]
[42] Bushman, F.D., Cantu, A., Everett, J., et al. (2021) Challenges in Estimating Numbers of Vectors Integrated in Gene-Modified Cells Using DNA Sequence Information. Molecular Therapy, 29, 3328-3331. [Google Scholar] [CrossRef] [PubMed]
[43] Pucci, F., Rickelt, S., Newton, A.P., et al. (2016) PF4 Promotes Platelet Production and Lung Cancer Growth. Cell Reports, 17, 1764-1772. [Google Scholar] [CrossRef] [PubMed]
[44] Xing, S., Zeng, T., Xue, N., et al. (2019) Development and Validation of Tumor-Educated Blood Platelets Integrin α 2b (ITGA2B) RNA for Diagnosis and Prognosis of Non-Small-Cell Lung Cancer through RNA-Seq. International Journal of Biological Sciences, 15, 1977-1992. [Google Scholar] [CrossRef] [PubMed]

为你推荐