多原发肺癌外科诊疗策略进展

Progress in diagnosis and treatment strategies for multiple primary lung cancer

多原发肺癌是一类特殊的肺癌,其检出率逐年攀升,且尚无明确诊断及治疗策略,多原发肺癌的诊疗成为临床工作中的热点。早期且准确的鉴别诊断决定治疗方法和预后,分子遗传学正逐步改变仅依靠影像学与无瘤间期来鉴别肺内转移瘤与多原发肺癌的现状,是鉴别诊断并预测肺癌生物学行为的有效方法。我们总结自身经验与多方研究,建议无禁忌证患者首选外科手术治疗,同时探讨了同期双侧胸腔镜手术治疗双侧多原发肺癌的优缺点,证明了其可行性与安全性。对于无法完全手术切除的病变,推荐积极外科局部治疗。多原发肺癌的诊断和治疗仍是临床上的难点,期待我们的研究能为临床工作者提供理论及实践指导。

Multiple primary lung cancer is a special type of lung cancer. Its detection rate is increasing year by year, and there is no clear diagnosis and treatment strategy, which makes the diagnosis and treatment become a hotspot in clinical work. The molecular genetics is gradually changing the status quo of relying only on imaging and tumor-free interval to distinguish lung metastasis from multiple primary lung cancer, and it is an effective method for differential diagnosis and prediction of biological behavior of lung cancer. Based on our experience and other studies, it is recommended that surgical treatment should be preferred when there is no contraindication. The advantages and disadvantages of bilateral thoracoscopic surgery for bilateral multiple primary lung cancer during the same period are discussed, and its feasibility and safety are confirmed. For the lesions that cannot be completely resected, active surgical local treatment is recommended. The diagnosis and treatment of multiple primary lung cancer is still a clinical difficulty,and we hope that our research can provide theoretical and practical guidance for clinicians.