Kammer Michael N, Massion Pierre P
Department of Chemistry, Vanderbilt University, Nashville, TN, USA.
Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
J Thorac Dis. 2020 Jun;12(6):3317-3330. doi: 10.21037/jtd-2019-ndt-10.
The 2010's saw demonstration of the power of lung cancer screening to reduce mortality. However, with implementation of lung cancer screening comes the challenge of diagnosing millions of lung nodules every year. When compared to other cancers with widespread screening strategies (breast, colorectal, cervical, prostate, and skin), obtaining a lung nodule tissue biopsy to confirm a positive screening test remains associated with higher morbidity and cost. Therefore, non-invasive diagnostic biomarkers may have a unique opportunity in lung cancer to greatly improve the management of patients at risk. This review covers recent advances in the field of liquid biomarkers and computed tomographic imaging features, with special attention to new methods for combination of biomarkers as well as the use of artificial intelligence for the discrimination of benign from malignant nodules.
2010年代见证了肺癌筛查降低死亡率的强大作用。然而,随着肺癌筛查的实施,每年诊断数百万个肺结节成为一项挑战。与采用广泛筛查策略的其他癌症(乳腺癌、结直肠癌、宫颈癌、前列腺癌和皮肤癌)相比,获取肺结节组织活检以确认筛查结果呈阳性仍伴随着更高的发病率和成本。因此,非侵入性诊断生物标志物在肺癌领域可能有独特的机会,极大地改善对高危患者的管理。本综述涵盖了液体生物标志物和计算机断层扫描成像特征领域的最新进展,特别关注生物标志物组合的新方法以及利用人工智能鉴别良性和恶性结节。