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直面同步性多原发性肺癌:挑战与机遇并存。

Confronting synchronous multiple primary lung cancers: Navigating the intersection of challenges and opportunities.

机构信息

Department of Thoracic Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China.

Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China.

出版信息

Lung Cancer. 2024 Nov;197:107994. doi: 10.1016/j.lungcan.2024.107994. Epub 2024 Oct 22.

Abstract

The increased detection of synchronous multiple primary lung cancers (sMPLC) through advanced computed tomography underscores the necessity for innovative therapeutic approaches. sMPLC typically manifests as ground-glass opacities, mixed ground-glass opacities, and/or solid nodules, predominantly in early-stage, non-smoking female patients, with a majority being adenocarcinomas. The high prevalence of EGFR mutations and considerable heterogeneity among lesions pose distinct diagnostic and therapeutic challenges for sMPLC. This study provides a comprehensive review and analysis of recent clinical and radiological studies, genomic profiling, and the efficacy of the "Surgery + X" treatment model for sMPLC. Additionally, the article discusses several intricate and complex sMPLC cases, shedding light on the disease's complexities and identifying existing gaps and potential breakthroughs in clinical diagnosis, treatment, and research. It underscores the critical role of a multidisciplinary approach and advocates for targeted research on sMPLC, highlighting its potential to impact lung cancer research significantly.

摘要

通过先进的计算机断层扫描技术检测到同步多发性原发性肺癌(sMPLC)的增加,凸显了创新治疗方法的必要性。sMPLC 通常表现为磨玻璃影、混合磨玻璃影和/或实性结节,主要发生在早期、非吸烟的女性患者中,大多数为腺癌。EGFR 突变的高发生率和病变之间的显著异质性对 sMPLC 的诊断和治疗构成了独特的挑战。本研究对 sMPLC 的近期临床和放射学研究、基因组分析以及“Surgery+X”治疗模式的疗效进行了全面回顾和分析。此外,文章还讨论了几个复杂的 sMPLC 病例,揭示了该疾病的复杂性,并确定了临床诊断、治疗和研究方面的现有差距和潜在突破。它强调了多学科方法的关键作用,并倡导针对 sMPLC 的靶向研究,突出了其对肺癌研究产生重大影响的潜力。

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