肺结节病因及形成机制的研究进展

Research progress on etiology and formation mechanism of pulmonary nodules

随着环境、遗传等多种因素的影响,胸部影像学体检筛查的普及,肺结节的检出率明显升高。本文介绍了引起肺结节的各种病因,包括感染性与非感染性肺结节,感染性肺结节包括细菌、真菌、病毒及其他病原体等引起,非感染性肺结节包括结节病、血管炎、肿瘤及其他。简述了各类肺结节的形成机制,涉及各种细胞因子、炎症介质、转运蛋白及信号通路的参与。现多将肺结节的病理机制归于慢性炎症反应、免疫反应或基因突变而致恶性增殖等因素作用,分析表明肺结节的发生发展基本以抗原呈递、细胞吞噬和加工抗原,释放细胞因子,使淋巴细胞和单核细胞聚集所致,以感染性相对常见。因此,掌握肺结节的发生及形成机制,可尽早干预,减少肺结节发生,为临床诊疗提供参考。

With the influence of environment,heredity and other factors,the prevalence of chest imaging screening has significantly increased the detection rate of pulmonary nodules.This paper introduces various causes of pulmonary nodules,including infectious and non infectious pulmonary nodules,infectious pulmonary nodules including bacteria,fungi,viruses and other pathogens,and non-infectious pulmonary nodules including sarcoidosis,vasculitis,tumors and.others.The formation mechanism of various pulmonary nodules,involving various cytokines,inflammatory mediators,transporters and signaling pathways,was briefly reviewed.Most of the pathological mechanisms of pulmonary nodules are attributed to factors such as chronic inflammation,immune response or malignant proliferation caused by gene mutation.Analysis shows that the occurrence and development of pulmonary nodules are basically caused by antigen presentation,cell phagocytosis and processing of antigens,release of cytokines,and aggregation of lymphocytes and monocytes,and infectivity is relatively common.Therefore,to grasp the occurrence and formation mechanism of pulmonary nodules,early intervention can reduce the occurrence of pulmonary nodules,and provide references for clinical diagnosis and treatment.