解剖性肺段切除术治疗早期肺癌适应证的研究进展

Advances in indications of anatomical pulmonary segmentectomy for early-stage lung cancer

目前对于解剖性肺段切除术是否可替代肺叶切除术治疗早期肺癌仍存在争议。数十年来大量临床研究在不断探索肺段切除术是否可以应用于早期肺癌的治疗,实际也就是探索意向性肺段切除术治疗早期肺癌的具体适应证。随着对肺癌研究的深入,发现多种特征影响肿瘤的恶性程度,不同特征的不同分级影响患者的生存预后,对于不同特征分类和分级的早期肺癌是否可采用不同手术方法值得探讨。本文回顾文献和现有研究,分别从肿瘤大小、实性成分占比、病理分型和肿瘤位置等方面,综述肺段切除术治疗早期肺癌适应证的研究进展,以帮助胸外科医生根据早期肺癌的临床特征客观、科学地选择手术方式。

Whether anatomical segmentectomy can replace lobectomy in the treatment of early-stage lung cancer remains controversial.A large number of studies have been conducted for decades to explore whether pulmonary segmentectomy can treat early-stage lung cancer,which is actually to explore the indications of intentional segmentectomy.With the development of scientific researches,it is found that many characteristics affect the malignancy of lung cancer,and the different grades of each characteristic affect the prognosis of patients.It is worth exploring whether different surgical approaches can be used for early-stage lung cancer with different characteristics and different grades.This article reviews the literature and studies to discuss the advances in indications of segmentectomy for early-stage lung in terms of tumor size,consolidation-to-tumor ratio,pathological classification and tumor location,respectively.The objective of this review is to help thoracic surgeons to objectively and scientifically select the surgical method according to the clinical characteristics of early-stage lung cancer.