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STAS:胸外科医生面临的新探索与挑战

STAS: New explorations and challenges for thoracic surgeons.

作者信息

Xia Teng, Yuan Qian, Xing Shi-Gui

机构信息

Department of Thoracic Surgery, Nan Jing Gaochun People's Hospital, The Gaochun Affiliated Hospital of Jiang Su University), Nanjing, 210000, Jiangsu, China.

出版信息

Clin Transl Oncol. 2025 Apr;27(4):1345-1355. doi: 10.1007/s12094-024-03681-4. Epub 2024 Sep 4.

DOI:10.1007/s12094-024-03681-4
PMID:39230858
Abstract

Spread through air spaces (STAS) represents a relatively novel concept in the pathology of lung cancer, and it specifically refers to the dissemination of tumour cells into the parenchymal air spaces adjacent to the primary tumour. In 2015, the World Health Organization (WHO) classified STAS as a new invasive form of lung adenocarcinoma (LUAD). Many studies investigated the role of STAS and revealed its association with the prognosis of LUAD and its influence on the outcomes of other malignant pulmonary neoplasms. Additionally, the underlying mechanisms and predictive models of STAS have received considerable attention in recent years. This paper provides a comprehensive overview of the research advancements and prospects of STAS by examining it from multiple perspectives.

摘要

气腔播散(STAS)在肺癌病理学中是一个相对较新的概念,它具体指肿瘤细胞扩散到原发肿瘤附近的实质气腔中。2015年,世界卫生组织(WHO)将STAS归类为肺腺癌(LUAD)的一种新的侵袭形式。许多研究调查了STAS的作用,并揭示了它与LUAD预后的关联及其对其他恶性肺肿瘤结局的影响。此外,近年来STAS的潜在机制和预测模型受到了相当多的关注。本文从多个角度审视STAS,对其研究进展和前景进行全面概述。

相似文献

1
STAS: New explorations and challenges for thoracic surgeons.STAS:胸外科医生面临的新探索与挑战
Clin Transl Oncol. 2025 Apr;27(4):1345-1355. doi: 10.1007/s12094-024-03681-4. Epub 2024 Sep 4.
2
[Progress on the Study of Tumor Spread Through Air Spaces in the Clinicopathological Characteristics of Lung Adenocarcinoma and Its Influence on the Surgical Treatment and Prognosis of Lung Cancer].[肿瘤经气腔播散在肺腺癌临床病理特征中的研究进展及其对肺癌外科治疗和预后的影响]
Zhongguo Fei Ai Za Zhi. 2019 Jun 20;22(6):363-368. doi: 10.3779/j.issn.1009-3419.2019.06.06.
3
Updates on spread through air spaces (STAS) in lung cancer.肺癌空气空间传播(STAS)的研究进展。
Histopathology. 2020 Aug;77(2):173-180. doi: 10.1111/his.14062. Epub 2020 Jul 1.
4
Significance of Spread Through Air Spaces in Resected Pathological Stage I Lung Adenocarcinoma.肺腺癌切除病理分期 I 中空气传播的意义。
Ann Thorac Surg. 2018 Jun;105(6):1655-1663. doi: 10.1016/j.athoracsur.2018.01.037. Epub 2018 Feb 14.
5
Clinical implication of tumour spread through air spaces in pathological stage I lung adenocarcinoma treated with lobectomy.肿瘤在经全胸腔镜肺叶切除术后Ⅰ期肺腺癌中空气传播的临床意义。
Interact Cardiovasc Thorac Surg. 2021 Jan 1;32(1):64-72. doi: 10.1093/icvts/ivaa227.
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Impacts of thoracoscopic surgery and high grade histologic subtypes on spread through air spaces in small stage I lung adenocarcinomas.胸腔镜手术和高级别组织学亚型对Ⅰ期小肺癌腺癌细胞经气道播散的影响。
J Cancer Res Clin Oncol. 2019 Sep;145(9):2375-2382. doi: 10.1007/s00432-019-02972-6. Epub 2019 Jul 10.
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Segmentectomy vs Lobectomy for Clinical Stage IA Lung Adenocarcinoma With Spread Through Air Spaces.肺段切除术与肺叶切除术治疗有空气传播途径的临床ⅠA 期肺腺癌
Ann Thorac Surg. 2021 Sep;112(3):935-943. doi: 10.1016/j.athoracsur.2020.09.020. Epub 2020 Nov 2.
8
[Research Progress on Spread Through Air Spaces of Lung Cancer].[肺癌在肺实质内播散的研究进展]
Zhongguo Fei Ai Za Zhi. 2022 Jan 20;25(1):54-60. doi: 10.3779/j.issn.1009-3419.2021.101.49. Epub 2021 Dec 23.
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Prognostic significance of tumor spread through air spaces in patients with stage IA part-solid lung adenocarcinoma after sublobar resection.肺段切除术后 IA 期部分实性肺腺癌患者肿瘤经气腔播散的预后意义
Lung Cancer. 2021 Feb;152:21-26. doi: 10.1016/j.lungcan.2020.12.001. Epub 2020 Dec 5.
10
Limited Resection Is Associated With a Higher Risk of Locoregional Recurrence than Lobectomy in Stage I Lung Adenocarcinoma With Tumor Spread Through Air Spaces.在以气腔播散为特征的Ⅰ期肺腺癌中,与肺叶切除术相比,局限性切除术与更高的局部区域复发风险相关。
Am J Surg Pathol. 2019 Aug;43(8):1033-1041. doi: 10.1097/PAS.0000000000001285.

引用本文的文献

1
Development and validation of a predictive model combining radiomics and deep learning features for spread through air spaces in stage T1 non-small cell lung cancer: a multicenter study.结合放射组学和深度学习特征的T1期非小细胞肺癌气腔播散预测模型的开发与验证:一项多中心研究
Front Oncol. 2025 May 8;15:1572720. doi: 10.3389/fonc.2025.1572720. eCollection 2025.
2
Concurrent spread through air spaces in dominant tumours impacts prognosis in synchronous multiple primary lung adenocarcinoma.优势肿瘤通过气腔的同时播散影响同步性多原发性肺腺癌的预后。
Eur J Cardiothorac Surg. 2025 Jun 3;67(6). doi: 10.1093/ejcts/ezaf163.
3

本文引用的文献

1
Association between tumor cell in air space and treatment outcomes in early-stage lung cancer treated with stereotactic body radiation therapy.早期肺癌立体定向体部放疗中肺泡内肿瘤细胞与治疗结果的相关性
Clin Transl Radiat Oncol. 2024 May 17;47:100795. doi: 10.1016/j.ctro.2024.100795. eCollection 2024 Jul.
2
Histology of Bronchiolar Tumor Spread Through Air Spaces.细支气管肿瘤空气传播的组织学。
Am J Surg Pathol. 2024 Aug 1;48(8):1052-1059. doi: 10.1097/PAS.0000000000002246. Epub 2024 May 17.
3
Prognostic impact of spread through air spaces in patients with ≤2 cm stage IA lung adenocarcinoma.
Prediction of STAS in lung adenocarcinoma with nodules ≤ 2 cm using machine learning: a multicenter retrospective study.
使用机器学习预测直径≤2 cm的肺腺癌中的STAS:一项多中心回顾性研究
BMC Cancer. 2025 Mar 7;25(1):417. doi: 10.1186/s12885-025-13783-z.
4
Feature-interactive Siamese graph encoder-based image analysis to predict STAS from histopathology images in lung cancer.基于特征交互暹罗图编码器的图像分析,用于从肺癌组织病理学图像预测STAS
NPJ Precis Oncol. 2024 Dec 20;8(1):285. doi: 10.1038/s41698-024-00771-y.
≤2 cm ⅠA期肺腺癌患者气腔播散的预后影响
J Thorac Dis. 2024 Apr 30;16(4):2432-2442. doi: 10.21037/jtd-24-444. Epub 2024 Apr 26.
4
Preoperative nomogram for predicting spread through air spaces in clinical-stage IA non-small cell lung cancer using F-fluorodeoxyglucose positron emission tomography/computed tomography.使用 F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描预测临床 IA 期非小细胞肺癌空气传播扩散的术前列线图。
J Cancer Res Clin Oncol. 2024 Apr 10;150(4):185. doi: 10.1007/s00432-024-05674-w.
5
The effect of spread through air spaces on postoperative recurrence-free survival in patients with multiple primary lung cancers.空气传播对多原发性肺癌患者术后无复发生存的影响。
World J Surg Oncol. 2024 Mar 5;22(1):75. doi: 10.1186/s12957-024-03351-3.
6
Significance of Spread Through Air Spaces and Vascular Invasion in Early-stage Adenocarcinoma Survival: A Comprehensive Clinicopathologic Study of 427 Patients for Precision Management.空气空间播散和脉管侵犯对早期腺癌生存的意义:427 例患者精准管理的综合临床病理研究。
Am J Surg Pathol. 2024 May 1;48(5):605-614. doi: 10.1097/PAS.0000000000002199. Epub 2024 Mar 4.
7
Prognosis of spread through air spaces in invasive mucinous lung adenocarcinoma after curative surgery.浸润性黏液型肺腺癌根治性手术后空气传播扩散的预后。
Eur J Surg Oncol. 2024 Apr;50(4):108053. doi: 10.1016/j.ejso.2024.108053. Epub 2024 Feb 22.
8
CT-Based Intratumoral and Peritumoral Radiomics Nomograms for the Preoperative Prediction of Spread Through Air Spaces in Clinical Stage IA Non-small Cell Lung Cancer.基于 CT 的肿瘤内和肿瘤周围放射组学列线图用于临床 IA 期非小细胞肺癌中空气空间扩散的术前预测。
J Imaging Inform Med. 2024 Apr;37(2):520-535. doi: 10.1007/s10278-023-00939-1. Epub 2024 Jan 10.
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Development and validation of a clinic-radiological model to predict tumor spread through air spaces in stage I lung adenocarcinoma.Ⅰ期肺腺癌气腔内播散的临床-影像学模型的建立与验证。
Cancer Imaging. 2024 Feb 9;24(1):25. doi: 10.1186/s40644-024-00668-w.
10
Spread Through Air Spaces in Stage I to III Resected Lung Adenocarcinomas: Should the Presence of Spread Through Air Spaces Lead to an Upstaging?Ⅰ期至Ⅲ期切除肺腺癌中的空气传播:空气传播是否会导致分期升级?
Am J Surg Pathol. 2024 May 1;48(5):596-604. doi: 10.1097/PAS.0000000000002188. Epub 2024 Feb 1.