North West Lung Centre, University Hospital South Manchester, Manchester, UK.
Cancer Research UK Lung Cancer Centre of Excellence at Manchester and University College London, UK.
Open Biol. 2017 Sep;7(9). doi: 10.1098/rsob.170070.
Lung cancer is the leading cause of cancer-related death in the world. It is broadly divided into small cell (SCLC, approx. 15% cases) and non-small cell lung cancer (NSCLC, approx. 85% cases). The main histological subtypes of NSCLC are adenocarcinoma and squamous cell carcinoma, with the presence of specific DNA mutations allowing further molecular stratification. If identified at an early stage, surgical resection of NSCLC offers a favourable prognosis, with published case series reporting 5-year survival rates of up to 70% for small, localized tumours (stage I). However, most patients (approx. 75%) have advanced disease at the time of diagnosis (stage III/IV) and despite significant developments in the oncological management of late stage lung cancer over recent years, survival remains poor. In 2014, the UK Office for National Statistics reported that patients diagnosed with distant metastatic disease (stage IV) had a 1-year survival rate of just 15-19% compared with 81-85% for stage I.
肺癌是全球癌症相关死亡的主要原因。它广泛分为小细胞肺癌（SCLC，约占 15%的病例）和非小细胞肺癌（NSCLC，约占 85%的病例）。非小细胞肺癌的主要组织学亚型是腺癌和鳞状细胞癌，存在特定的 DNA 突变允许进一步的分子分层。如果在早期发现，NSCLC 的手术切除提供了良好的预后，发表的病例系列报告显示，小的、局限性肿瘤（I 期）的 5 年生存率高达 70%。然而，大多数患者（约 75%）在诊断时已经处于晚期疾病（III/IV 期），尽管近年来晚期肺癌的肿瘤治疗取得了重大进展，但生存仍然很差。2014 年，英国国家统计局报告称，诊断为远处转移疾病（IV 期）的患者的 1 年生存率仅为 15-19%，而 I 期的生存率为 81-85%。
