气腔扩散对早期非小细胞肺癌亚肺叶切除影响的研究进展  

Research progress on the effect of tumor spread through air spaces in sublobar resection for early-stage non-small cell lung cancer

作　　者：彭岚 唐东昕 杨柱 吴娇 李高 杨兵 罗竹敏 夏子寒 徐家栋(综述) 吴文宇(审校) Lan Peng;Dongxin Tang;Zhu Yang;Jiao Wu;Gao Li;Bing Yang;Zhumin Luo;Zihan Xia;Jiadong Xu;Wenyu Wu(Guizhou University of Traditional Chinese Medicine,Guiyang 550002,China;Department of Oncology,The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550001,China)

机构地区：[1]贵州中医药大学,贵阳市550002 [2]贵州中医药大学第一附属医院肿瘤科

出　　处：《中国肿瘤临床》2025年第1期34-39,共6页Chinese Journal of Clinical Oncology

基　　金：贵州省高等学校中医药民族医药防治肿瘤医学转化工程研究中心(编号:黔教技037号);贵州省科技计划项目(编号:黔科合基础-ZK一般498,黔科合基础-ZK一般487,黔科合支撑一般095);贵州省中医肿瘤传承与科技创新人才基地(编号:黔人领发3号);贵州省高层次创新型人才培养计划(百层次)(编号:黔科合人才4032号);贵州省杨柱“中医肿瘤学”研究生导师工作室(编号:黔教研合GZS字08);中医肿瘤学研究生工作站(编号:黔教研合JYSZ字018)资助。

摘　　要：非小细胞肺癌(non-small cell lung cancer,NSCLC)是全球最常见且致命的恶性肿瘤之一,早期NSCLC以手术切除为主要治疗手段。肿瘤经气腔扩散(spread through air spaces,STAS)是一种肿瘤向肺部气腔扩散的新型传播模式,其与亚肺叶切除术后的发生、复发和远处转移密切相关,使其成为手术方式选择和预后评估中至关重要的考虑因素。STAS阳性患者的术后复发率显著高于STAS阴性患者,其分子机制涉及肿瘤微环境的重塑、特异性基因突变及上皮-间质转化等过程。包括计算机断层扫描(CT)和正电子发射断层扫描/CT在内的影像技术已显示出术前预测STAS的潜力,但其准确性和可操作性仍有待提升。本文综述了STAS的定义、病理特征及相关机制,重点探讨STAS阳性患者的手术方式选择及其在早期NSCLC亚肺叶切除术后癌症复发中的作用,并提出未来研究方向,包括优化STAS的术前诊断方法、探索分子靶向治疗以及建立基于影像学的精准预测模型。Non-small cell lung cancer(NSCLC)is one of the most common and deadly malignant tumors worldwide,with surgical resection being the primary treatment for early-stage NSCLC.Tumor spread through air spaces(STAS)is a novel pattern of tumor dissemination into the air spaces in the lung.Its occurrence after sublobar resection is closely associated with recurrence and distant metastasis,making its consideration a vital factor in surgical strategy selection and prognostic evaluation.Patients with STAS-positive status exhibit significantly higher postoperative recurrence rates than do STAS-negative patients,with molecular mechanisms involving tumor microenvironment remodeling,specific genetic mutations,and epithelial-mesenchymal transition(EMT).Imaging techniques including computed tomography(CT)and positron emission tomography/CT have shown potential for preoperative STAS prediction,although their accuracy and practicality require improvement.This paper reviews the definition,pathological characteristics,and related mechanisms of STAS,with a focus on surgical approach selection for STAS-positive patients and its role in cancer recurrence after sublobar resection of early-stage NSCLC.Future research directions include optimization of preoperative diagnostic methods for STAS,exploration of molecular targeted therapies,and development of imaging-based precision prediction models.

关 键 词：非小细胞肺癌 气腔扩散 亚肺叶切除术 肿瘤复发 分子机制 

分 类 号：R734.2[医药卫生—肿瘤]