[Advances in Diagnosis and Treatment of Multiple Primary Lung Cancer]

Zhongguo Fei Ai Za Zhi. 2015 Oct 20;18(10):640-3. doi: 10.3779/j.issn.1009-3419.2015.10.07.
[Article in Chinese]

Abstract

Recently, the incidence and detection rates of multiple primary lung cancer (MPLC) are increasing. The diagnosis of MPLC depends mainly on the Martini-Melamed criterion and ACCP criterion at present, taking all features (histological, genetic, radiologic and clinical) into account. It may be easy to diagnose cases of MPLC that exhibit different histological types, but it is difficult to diagnose cases that exhibit similar histological type. DNA polity, gene mutations, microsatellite alteration and so on provide new methods for the accurate diagnosis of MPLC. They can evaluate the clonal relationship and help differential diagnosis between MPLC and metastasis. The first therapeutic choice for MPLC is curative operation. The surgical approach includes lobectomy, wedge resection and segmentectomy. For those which cannot be resected, we can synthesize chemotherapy, radiotherapy, stereotactic ablative radiotherapy (SABR), radiofrequency ablation (RFA), molecular targeted therapy, etc.

多原发性肺癌的发病率和检出率逐年升高。目前临床上诊断多原发性肺癌(multiple primary lung cancer, MPLC)主要参照Martini-Melamed标准和美国胸科医师协会(American College of Chest Physicians, ACCP)标准,综合考虑临床表现、影像学特征、组织学类型和分子遗传学特征。组织学类型不同的MPLC诊断相对容易,而组织学类型相同的MPLC诊断仍相当困难。DNA倍体分析、基因突变检测、微卫星多态性分析等分子生物学技术为MPLC的正确诊断提供了新手段,可评估各病灶的克隆性关系,帮助鉴别MPLC与转移。MPLC的首选治疗方案为根治性手术,术式应考虑患者肺功能储备等因素,选择肺叶切除、肺段切除或楔形切除;对于不能根治性切除的病灶,可综合化疗、放疗、立体定向放疗(stereotactic ablative radiotherapy, SABR)、射频消融(radiofrequency ablation, RFA)、分子靶向治疗等。.

Publication types

  • English Abstract
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / therapeutic use
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / radiotherapy

Substances

  • Antineoplastic Agents

Grants and funding

本研究受国家自然科学基金项目(No.81372504)和四川省科技项目(No.S2014SZ0148)资助