Schlesser M, Berchem G J, Nati R
Services de Pneumologie et d'Hémato-Cancérologie, Centre Hospitalier du Luxembourg.
Bull Soc Sci Med Grand Duche Luxemb. 1999(2):45-57.
Due to the frequent diagnosis at a late inoperable stage and the bad prognosis of metastatic disease, lung cancer has become the first cause of cancer mortality. Early detection is thus the only way to influence mortality as there is no good treatment available for advanced disease. In the eighties, large screening studies using standard chest X Ray and sputum cytology have not been able to show a significant reduction in global lung cancer mortality. However these studies are now largely criticized for their methodological flaws. Recently, a new technique using auto-fluorescence fibroscopy has been developed, which is able to detect dysplastic and in situ neoplastic lesions which are invisible to standard fibroscopic techniques. This technique holds great promise in the detection of early lesions. In addition, molecular biology techniques are being developed which aim at detecting early invasive lesions at a stage where surgical treatment is still curative. The addition of these two techniques will probably in the future increase the efficiency of lung cancer screening. Therefore we think that new large scale screening studies are needed.
由于肺癌常在晚期无法手术阶段被诊断出来，且转移性疾病预后不良，肺癌已成为癌症死亡的首要原因。因此，早期检测是影响死亡率的唯一途径，因为对于晚期疾病没有有效的治疗方法。在20世纪80年代，使用标准胸部X光和痰细胞学的大型筛查研究未能显示全球肺癌死亡率有显著降低。然而，这些研究现在因其方法学缺陷而受到广泛批评。最近，一种使用自体荧光纤维镜检查的新技术已经开发出来，它能够检测到标准纤维镜检查技术无法看到的发育异常和原位肿瘤病变。这项技术在早期病变检测方面具有很大的前景。此外，分子生物学技术也在不断发展，旨在在手术治疗仍可治愈的阶段检测早期浸润性病变。这两种技术的结合可能会在未来提高肺癌筛查的效率。因此，我们认为需要开展新的大规模筛查研究。
