偶然发现的肺结节的生物学、检测和管理：靶向治疗的新兴作用。当前文献和未来展望的综述
Biology, detection, and management of incidental pulmonary nodules: the emerging role of targeted treatments. A review of the current literature and future perspectives.
作者
作者单位
- Department of Haematology-Oncology, National University Cancer Institute Singapore, National University Health System, Singapore, Singapore. Electronic address: ross_soo@nuhs.edu.sg.
- Center for Lung Cancer, National Cancer Center, Goyang, Republic of Korea.
- Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China.
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore.
- Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA.
- Lung Unit, Royal Marsden Hospital, Chelsea, London, UK; Division of Clinical Studies, Institute of Cancer Research, London, UK.
摘要
中文
肺癌是全球癌症相关死亡的主要原因，早期诊断和治疗对于改善预后很重要。肺结节（PNs）是临床实践中经常发现的小型肺部病变，随着成像技术的进步和CT扫描在胸部评估中的广泛应用，偶然检测到的情况越来越多。大多数偶然发现的肺结节（IPNs）是良性的，但有些代表早期肺癌，因此区分良恶性IPNs是改善肺癌预后的关键。当前管理指南因结节类型而异，并涉及活检以确定结节的恶性状态。在这里，我们回顾了关于PNs分类、患病率和检测的当前知识，以及PNs的当前管理和风险分层。我们概述了致癌驱动突变在PNs病理生物学中的作用，并评估了当前关于驱动基因驱动的PNs靶向治疗的文献。最后，我们讨论了证据差距和未来研究领域。
English
Lung cancer is the leading cause of cancer-related deaths globally, and early diagnosis and treatment are important for improving prognosis. Pulmonary nodules (PNs) are small pulmonary lesions frequently identified during clinical practice, with incidental detection increasing due to advances in imaging techniques and the expanded use of computed tomography scans for thoracic evaluation. The majority of incidental PNs (IPNs) are benign, however some represent early-stage lung cancer, therefore distinguishing benign from malignant IPNs is key to improving lung cancer outcomes. Current management guidelines differ by nodule type and involve biopsy to determine the malignancy status of the nodule. Here, we review current knowledge on the classification, prevalence, and detection of PNs, as well as the current management and risk stratification of PNs. We outline the role of oncogenic driver mutations in the pathobiology of PNs and assess current literature on targeted treatment of oncogene-driven PNs. Finally, we discuss evidence gaps and areas for future research.
分类与指标
- 研究类型
- 综述Meta
- 病种
- 肺癌
- JCR 分区
- Q1
- 影响因子
- 5.3
- 新锐分区
- 2区