Department of Internal Medicine, College of Medicine, Kosin University, Busan, Republic of Korea.
Mol Med Rep. 2012 Nov;6(5):931-6. doi: 10.3892/mmr.2012.1042. Epub 2012 Aug 21.
Lung cancer is the leading cause of mortality from cancer among men and women worldwide. More individuals die each year of lung cancer than of colon, breast and prostate cancer combined. Despite new diagnostic techniques, the overall 5-year survival rate remains at approximately 15% and the majority of patients still present with advanced disease. Therefore, lung cancer is the most lethal cancer at present. Diagnosing and treating cancer at its early stages, ideally during the precancerous stages, could increase the 5-year survival rate by 3-4‑fold, with the possibility of cure. To date, no screening method has been shown to decrease the disease-specific mortality rate. This review describes issues related to early lung cancer screening and their rationale, the management of primary cancers detected by screening and the different approaches that have been tested for cancer screening; these include imaging techniques, bronchoscopies and molecular screening, such as analysis of epigenomics using different noninvasive or invasive sources, such as blood, sputum, bronchoscopic samples and exhaled breath.
肺癌是全世界男性和女性癌症死亡的主要原因。每年死于肺癌的人数超过结肠癌、乳腺癌和前列腺癌的总和。尽管有新的诊断技术，但总体 5 年生存率仍约为 15%，大多数患者仍处于晚期疾病。因此，肺癌是目前最致命的癌症。在癌症早期，理想情况下在癌前阶段进行诊断和治疗，可以将 5 年生存率提高 3-4 倍，并有可能治愈。迄今为止，尚无筛查方法显示可降低疾病特异性死亡率。本文综述了与早期肺癌筛查相关的问题及其原理、筛查发现的原发性癌症的管理，以及已经测试过的不同癌症筛查方法；这些方法包括影像学技术、支气管镜检查和分子筛查，例如使用不同的非侵入性或侵入性来源（如血液、痰液、支气管镜样本和呼气）分析表观基因组学。
