重视精准智慧医疗研究,积极应对骨肿瘤诊治发展趋势

Emphasis on precision intelligent medical research,positive response to the development trend of bone tumor diagnosis and treatment

自实施以手术为主的综合疗法以来,骨肿瘤的诊断方法和治疗水平有了很大的进步和突破。原发性恶性骨肿瘤的生存率明显提高,如骨肉瘤五年生存率从原来的5%~20%提高至60%~70%。骨肿瘤的特点是:(1)发病部位广;(2)肿瘤类型多;(3)肿瘤异质性高;(4)结构和功能重建并重;(5)转移性肿瘤多于原发性肿瘤。基于上述特点,骨肿瘤的诊断须遵循临床、影像、病理三结合的基本原则;在遵循肿瘤切除原则达到局部控制的基础上,还要进行有效的骨与软组织结构性缺损重建和获得尽量完美的运动功能。由于基因研究、生物信息技术、数字医学及计算机技术的发展,骨肿瘤的诊疗已经进入具有精确、准时、共享和个体化四大特征的精准医学阶段。利用基因组学、转录组学、蛋白组学和代谢组学等技术探索骨肿瘤发生、发展机制,寻找新靶向基因,为未来精准医疗在骨肿瘤中的应用提供了方向。应用基于人工智能的智慧医疗对骨肿瘤的辅助诊断和精准治疗具有重要意义。

Since the implementation of surgery-based comprehensive treatment,there have been great advances and breakthroughs in the diagnosis and treatment of bone tumors.The survival rate of primary malignant bone tumors has significantly improved,for example,the 5-year survival rate of osteosarcoma has increased from 5%-20%to 60%-70%.Characteristics of bone tumors are as follows:(1)have a wide range of lesion sites;(2)various types;(3)high heterogeneity;(4)structural reconstruction is as important as functional reconstruction;(5)metastatic tumors are more common than primary tumors.Based on the characteristics above,the combination of clinical,imaging and pathology is the basic principle in the diagnosis of bone tumors;Following the principle of tumor resection to achieve local control,it is necessary not only to carry out effective reconstruction of bone and soft tissue structural defects,but also to obtain as perfect motor function as possible.Due to the development of genetic research,bioinformatics technology,digital medicine and computer technology,the diagnosis and treatment of bone tumors have entered the stage of precision medicine with four characteristics:accuracy,punctuality,sharing and individualization.Using the multi-omics technology of genomics,transcriptomics,proteomics and metabolomics to explore the mechanism of the occurrence and development of bone tumors and find new target genes provides a direction for the application of precision medicine in bone tumors in the future.The application of Wise Information Technology of med based on artificial intelligence is of great significance for the auxiliary diagnosis and precise treatment.