Graham Pamela D, Thigpen S Calvin, Geraci Stephen A
From the G.V. (Sonny) Montgomery VA Medical Center, and the Department of Medicine, University of Mississippi School of Medicine, Jackson, and the Department of Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City.
South Med J. 2013 Oct;106(10):582-7. doi: 10.1097/SMJ.0000000000000004.
Lung cancer is the deadliest cancer in women. In the last decade, the first measurable decline in disease-related mortality has occurred and in the last 5 years, the first decline in lung cancer incidence in women in the United States has been reported. Five-year survival rates are much higher in early-stage disease, making effective screening a priority. Data on screening with low-dose computed tomography are controversial; existing guidelines are not sex specific and recommend testing only for patients at high risk for the disease. Although cigarette smoking remains the predisposing factor that is most often associated with tumor development, the advent of molecularly targeted therapy and the growing evidence that susceptible targets are more prevalent in never-smoking women have brought more attention to this particular subpopulation. Studies of both surgery and systemic therapy suggest that not only never-smoking women but also women overall experience better outcomes than men. Identifying all of the factors contributing to these sex differences presents us with an opportunity to identify potentially a distinct tumor biology in women who would warrant a distinct personalized treatment approach.
肺癌是女性中最致命的癌症。在过去十年中，首次出现了与疾病相关死亡率的可测量下降，并且在过去五年中，美国首次报告了女性肺癌发病率的下降。早期疾病的五年生存率要高得多，因此有效的筛查成为当务之急。低剂量计算机断层扫描筛查的数据存在争议；现有指南并非针对特定性别，仅建议对该疾病的高危患者进行检测。虽然吸烟仍然是最常与肿瘤发展相关的诱发因素，但分子靶向治疗的出现以及越来越多的证据表明易感靶点在从不吸烟的女性中更为普遍，这使得这个特定亚群受到了更多关注。手术和全身治疗的研究表明，不仅从不吸烟的女性，而且总体而言女性比男性的治疗效果更好。确定导致这些性别差异的所有因素，为我们提供了一个机会，有可能识别出女性中独特的肿瘤生物学特征，从而需要一种独特的个性化治疗方法。
