Li Caichen, Wang Huiting, Jiang Yu, Fu Wenhai, Liu Xiwen, Zhong Ran, Cheng Bo, Zhu Feng, Xiang Yang, He Jianxing, Liang Wenhua
Department of Thoracic Oncology and Surgery, the First Affiliated Hospital of Guangzhou Medical University, China National Center for Respiratory Medicine, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China.
Dongguan Affiliated Hospital of Southern Medical University, Dongguan People Hospital, Dongguan 523059, China.
Cancer Biol Med. 2022 May 11;19(5):591-608. doi: 10.20892/j.issn.2095-3941.2021.0690.
Lung cancer is associated with a heavy cancer-related burden in terms of patients' physical and mental health worldwide. Two randomized controlled trials, the US-National Lung Screening Trial (NLST) and Nederlands-Leuvens Longkanker Screenings Onderzoek (NELSON), indicated that low-dose CT (LDCT) screening results in a statistically significant decrease in mortality in patients with lung cancer, LDCT has become the standard approach for lung cancer screening. However, many issues in lung cancer screening remain unresolved, such as the screening criteria, high false-positive rate, and radiation exposure. This review first summarizes recent studies on lung cancer screening from the US, Europe, and Asia, and discusses risk-based selection for screening and the related issues. Second, an overview of novel techniques for the differential diagnosis of pulmonary nodules, including artificial intelligence and molecular biomarker-based screening, is presented. Third, current explorations of strategies for suspected malignancy are summarized. Overall, this review aims to help clinicians understand recent progress in lung cancer screening and alleviate the burden of lung cancer.
在全球范围内，肺癌给患者的身心健康带来了沉重的癌症相关负担。两项随机对照试验，即美国国家肺癌筛查试验（NLST）和荷兰-鲁汶肺癌筛查研究（NELSON）表明，低剂量CT（LDCT）筛查可使肺癌患者的死亡率在统计学上显著降低，LDCT已成为肺癌筛查的标准方法。然而，肺癌筛查中的许多问题仍未得到解决，如筛查标准、高假阳性率和辐射暴露等。本综述首先总结了美国、欧洲和亚洲近期关于肺癌筛查的研究，并讨论了基于风险的筛查选择及相关问题。其次，介绍了用于肺结节鉴别诊断的新技术概述，包括人工智能和基于分子生物标志物的筛查。第三，总结了目前对疑似恶性肿瘤策略的探索。总体而言，本综述旨在帮助临床医生了解肺癌筛查的最新进展并减轻肺癌负担。
