Xiang Xingyu, Nan Yandong
Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Air Force Medical University, Xi'an 710038, China.
Zhongguo Fei Ai Za Zhi. 2024 Sep 20;27(9):697-703. doi: 10.3779/j.issn.1009-3419.2024.106.24.
Small cell lung cancer (SCLC) is a type of lung cancer with high malignant degree, rapid transformation, rapid invasion and metastasis, which is prone to early metastasis and poor prognosis. Bone metastases of SCLC occur in three stages: cancer cells proliferate at the primary site, break through local tissues, enter the blood circulation to form circulating tumor cells (CTCs), reach bone tissue through blood circulation, and take root and germinate to form new tumor sites with the support of the bone microenvironment. However, traditional imaging and pathology examinations have disadvantages such as low sensitivity, high cost and difficulty in implementation. Exploratory studies based on blood marker detection as screening and efficacy evaluation of SCLC bone metastases have been reported in recent years. By reviewing the molecular biological mechanism of SCLC bone metastasis formation, this paper found that conventional diagnostic methods such as imaging and pathological biopsy were inadequate in SCLC bone metastasis. The changes in hyaluronic acid, protein biomarkers, non-coding RNA, and biomarkers in liquid biopsy were earlier than the changes in imaging, which had the advantages of simple operation and good repeatability. It provides a new idea and method for the early diagnosis of SCLC bone metastasis, which is worthy of clinical application. .
小细胞肺癌（SCLC）是一种恶性程度高、转化快、侵袭和转移迅速的肺癌，容易早期转移且预后较差。SCLC的骨转移发生在三个阶段：癌细胞在原发部位增殖，突破局部组织，进入血液循环形成循环肿瘤细胞（CTC），通过血液循环到达骨组织，并在骨微环境的支持下生根发芽形成新的肿瘤部位。然而，传统的影像学和病理学检查存在灵敏度低、成本高和实施困难等缺点。近年来，已有基于血液标志物检测作为SCLC骨转移筛查和疗效评估的探索性研究报道。通过回顾SCLC骨转移形成的分子生物学机制，本文发现影像学和病理活检等传统诊断方法在SCLC骨转移方面存在不足。透明质酸、蛋白质生物标志物、非编码RNA以及液体活检中的生物标志物变化早于影像学变化，具有操作简单、重复性好的优点。它为SCLC骨转移的早期诊断提供了新的思路和方法，值得临床应用。
