Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy.
Department of Molecular Medicine, University of Pavia, Pavia, Italy
J Breath Res. 2018 Feb 6;12(2):027111. doi: 10.1088/1752-7163/aa9386.
Lung cancer is the leading cause of death for neoplasm. Lung cancer mortality is frequently associated with late diagnosis, therefore an early diagnosis is a key factor to significantly improve overall survival in high risk populations of asymptomatic patients. Conventional cancer screenings (low-dose computed tomography or chest x-ray) today offer early detection but are invasive and expensive. Previously these studies evaluated the solid and topographic cancer structure and morphology. Today the concept of tumor has been remodelled, being defined as a disease that has its own genetic, biological and metabolic identity; it is on this new awareness that we should base new screening methods. Recent research has shown great reliability of new tests such as exhaled breath analysis, serum biomarkers and urine analysis in early diagnosis of lung cancer. Analysis of new biomarkers associated with the high specificity of these new screening methods, which are non-invasive, safe, inexpensive and simple to perform, could allow a non-invasive approach to determine a big change in the early diagnosis of cancer and its survival rate. Furthermore, these new techniques put the patient at the core of a non-invasive diagnostic process and ensure a better quality of life during medical diagnosis. In this article, we want to analyze the possible benefits of these new and promising methods, suggesting a possible combination between them to ensure, as soon as possible, an early and effective diagnosis of lung cancer with a special focus on the patient, in a new era of personalized medicine.
肺癌是导致肿瘤死亡的主要原因。肺癌死亡率常常与晚期诊断有关,因此早期诊断是显著改善无症状高危人群总体生存率的关键因素。目前常规的癌症筛查(低剂量计算机断层扫描或胸部 X 光)可以实现早期发现,但具有侵入性且昂贵。这些研究以前评估的是实体和地形癌症结构和形态。如今,肿瘤的概念已经被重新构建,被定义为一种具有自身遗传、生物学和代谢特征的疾病;我们应该基于这一新的认识来开发新的筛查方法。最近的研究表明,呼气分析、血清生物标志物和尿液分析等新检测方法在肺癌的早期诊断中具有很高的可靠性。分析与这些新的筛查方法高度特异性相关的新生物标志物,这些新的筛查方法具有非侵入性、安全、经济且易于操作的特点,可能可以实现非侵入性方法来确定癌症早期诊断和生存率的重大改变。此外,这些新技术将患者置于非侵入性诊断过程的核心,并确保在医疗诊断期间提高生活质量。在本文中,我们希望分析这些新的、有前途的方法的可能益处,并建议将它们结合使用,以确保尽早有效地诊断肺癌,特别是在个性化医疗的新时代,要特别关注患者。