肺癌筛查的研究进展  

Research Progress of Lung Cancer Screening

作　　者：王林[1] 王祖义[1] 汪国文[1] 

机构地区：[1]蚌埠医学院第一附属医院胸心外科,安徽蚌埠233000

出　　处：《中国胸心血管外科临床杂志》2014年第2期258-263,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：肺癌是目前世界上发病率最高的恶性肿瘤之一,而其每年死亡人数已居所有恶性肿瘤之首。其中80%的患者就诊时已属晚期,丧失了手术的机会。在所有手术患者中,TNM分期较早的患者,其5年死亡率远远低于晚期患者。随着医疗设备的改进及其体检人群的增加,较多肺部小结节患者被发现,使用电子胸腔镜进行有限地肺切除,包括肺楔形切除或肺段切除等,使得这部分患者以较小的治疗代价取得了不亚于传统肺叶切除术的良好效果;同时其生存质量远远优于后者。肺癌筛查能更多地诊断早期癌变,使患者能够在早期就得到合理地诊治,这可以大大降低治疗成本及病死率,以最小的经济及医疗代价取得最大的治疗收益。本文结合一些肺癌筛查指南及试验研究,通过对肺癌筛查的必要性、高危人群、评价标准、筛查方法等的讨论,以期得到合理的筛查策略,能为临床肺癌筛查工作提供较为可行的参考。Currently,lung cancer （LC） has one of the highest incidence rates among various malignant tumors worl-dwide,and the annual mortality rate of LC has ranked first among all malignant tumors. About 80% of LC patients present to the hospital in a late advanced stage and lose the chance of surgical resection. Among all the patients who receive surgicaltreatment,the 5-year mortality rate of patients with early TNM stages is far lower than that of patients with advanced stageLC. With the advancement of medical equipment and more people who receive routine medical examination,more and morepatients with small pulmonary nodules are discovered. Limited lung resection,including wedge resection and segmentalresection,can be performed with minimally invasive video-assisted thoracoscopic surgery for these patients to acquire equiv-alent surgical outcomes as traditional lobectomy and a much better postoperative quality of life. LC screening increases the chances of early detection and diagnosis of LC patients,so these patients can receive reasonable diagnosis and treatment at an early stage. This strategy can greatly reduce treatment cost and mortality,and achieve maximal treatment benefits with minimal economic and medical cost. This review focuses on the necessity,high-risk groups,evaluation criteria and methodsof LC screening with some LC screening guidelines and research studies in order to provide reasonable and feasible screeningstrategies and references for clinical LC screening.

关 键 词：肺癌 筛查 策略 

分 类 号：R734.2[医药卫生—肿瘤]