肺癌气道播散的研究概况

2015年,世界卫生组织对肺癌的分类提出了气道播散(spread through air spaces,STAS)的概念,作为肺腺癌侵袭的新模式。STAS指的是肺癌细胞在肺实质内经气道播散到肿瘤主灶边缘以外。近年来,随着对STAS研究的深入,研究结果表明STAS作为一种侵袭方式与其他侵袭行为和转移有关。STAS与肺癌的预后存在密切联系,并且与复发的风险独立相关。而选择的手术方式不同,STAS阳性患者的预后大不相同。在影像学方面,STAS有着其特殊的影像学特征,这些影像学特征可以作为STAS可能性估计的工具。因此能否通过影像学等方法判断出是否有STAS存在对选择手术方式和改善患者预后有重要指导意义。这篇综述将重点阐述近年来STAS在与不同类型肺癌的联系、影像学、基因突变等方面的研究概况。

Research Overview on Spreading Through Air Spaces of Lung Cancer

ABSTRACT: In 2015, the World Health Organization''s classification of lung cancer proposed the concept of spread through air spaces (STAS) as a new model for lung adenocarcinoma invasion. STAS refers to the spread of lung cancer cells through the airways in the lung parenchyma beyond the edge of the main tumor. In recent years, with the deepening of STAS research, the results show that STAS as an invasive method is related to other invasive behaviors and metastasis. STAS is closely related to the prognosis of lung cancer and is also independently associated with the risk of recurrence. Notably, the prognosis of STAS-positive patients varies greatly with the choice of surgical methods. In imaging, STAS has its own special imaging features that can be used as a tool for estimating STAS likelihood. Therefore, whether it is possible to determine the presence or absence of STAS by imaging and other methods could become a significant guidance for selecting surgical methods and improving patients'' prognosis. This review will focus on the recent research on the association of STAS with imaging, gene mutations, and different types of lung cancer.