Lung cancer is the most common and fatal malignant disease worldwide and has the highest mortality rate among tumor-related causes of death.Early diagnosis and precision medicine can significantly improve the survival...Lung cancer is the most common and fatal malignant disease worldwide and has the highest mortality rate among tumor-related causes of death.Early diagnosis and precision medicine can significantly improve the survival rate and prognosis of lung cancer patients.At present,the clinical diagnosis of lung cancer is challenging due to a lack of effective non-invasive detection methods and biomarkers,and treatment is primarily hindered by drug resistance and high tumor heterogeneity.Liquid biopsy is a method for detecting circulating biomarkers in the blood and other body fluids containing genetic information from primary tumor tissues.Bronchoalveolar lavage fluid(BALF)is a potential liquid biopsy medium that is rich in a variety of bioactive substances and cell components.BALF contains information on the key characteristics of tumors,including the tumor subtype,gene mutation type,and tumor environment,thus BALF may be used as a diagnostic supplement to lung biopsy.In this review,the current research on BALF in the diagnosis,treatment,and prognosis of lung cancer is summarized.The advantages and disadvantages of different components of BALF,including cells,cell-free DNA,extracellular vesicles,and micro RNA are introduced.In particular,the great potential of extracellular vesicles in precision diagnosis and detection of drug-resistant for lung cancer is highlighted.In addition,the performance of liquid biopsies with different body fluid sources in lung cancer detection are compared to facilitate more selective studies involving BALF,thereby promoting the application of BALF for precision medicine in lung cancer patients in the future.展开更多
目的探讨在中国肺腺癌患者中,吸烟对组织形态学特征及预后的影响。方法 266例原发性肺腺癌患者按照2011年肺腺癌国际肺癌研究协会/美国胸科学会/欧洲呼吸学会(International Association for the Study of Lung Cancer/American Thoraci...目的探讨在中国肺腺癌患者中,吸烟对组织形态学特征及预后的影响。方法 266例原发性肺腺癌患者按照2011年肺腺癌国际肺癌研究协会/美国胸科学会/欧洲呼吸学会(International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society, IASLC/ATS/ERS)新分类方法进行组织学亚型重新分类,分析吸烟状况等各种临床病理特征与组织学亚型的关系以及对患者术后生存期的影响。结果组织学亚型主要为腺泡状为主型(30.1%)、乳头状为主型(26.7%)、实体状为主型(25.9%)、贴壁状为主型(11.7%)。吸烟状况与组织学亚型有关,实体状为主型患者组中,吸烟患者所占比例高于不吸烟患者,而其它亚型组中则均为不吸烟患者所占比例更高(P<0.05)。Cox比例风险回归模型分析显示,在整体患者中,组织学亚型及TNM分期是术后生存期的预测因子;将患者分为吸烟患者和不吸烟患者,TNM分期在两类患者中均为术后生存期的预测因子,而组织学亚型则只在吸烟患者中显示对预后有显著性影响[标准偏回归系数(B)=0.898,相对危险度(RR)=2.455],与非实体状为主型患者比较,实体状为主患者的预后明显较差。结论吸烟与实体状为主亚型关联,并进一步对预后造成影响。展开更多
基金supported by grants from the National Natural Science Foundation of China(Grant No.82173182)the Sichuan Science and Technology Program(Grant No.2021YJ0117 to Weiya Wang+1 种基金Grant No.2023NSFSC1939 to Dan Liu)the 1·3·5 project for Disciplines of Excellence–Clinical Research Incubation Project,West China Hospital,Sichuan University(Grant Nos.2019HXFH034 and ZYJC21074)。
文摘Lung cancer is the most common and fatal malignant disease worldwide and has the highest mortality rate among tumor-related causes of death.Early diagnosis and precision medicine can significantly improve the survival rate and prognosis of lung cancer patients.At present,the clinical diagnosis of lung cancer is challenging due to a lack of effective non-invasive detection methods and biomarkers,and treatment is primarily hindered by drug resistance and high tumor heterogeneity.Liquid biopsy is a method for detecting circulating biomarkers in the blood and other body fluids containing genetic information from primary tumor tissues.Bronchoalveolar lavage fluid(BALF)is a potential liquid biopsy medium that is rich in a variety of bioactive substances and cell components.BALF contains information on the key characteristics of tumors,including the tumor subtype,gene mutation type,and tumor environment,thus BALF may be used as a diagnostic supplement to lung biopsy.In this review,the current research on BALF in the diagnosis,treatment,and prognosis of lung cancer is summarized.The advantages and disadvantages of different components of BALF,including cells,cell-free DNA,extracellular vesicles,and micro RNA are introduced.In particular,the great potential of extracellular vesicles in precision diagnosis and detection of drug-resistant for lung cancer is highlighted.In addition,the performance of liquid biopsies with different body fluid sources in lung cancer detection are compared to facilitate more selective studies involving BALF,thereby promoting the application of BALF for precision medicine in lung cancer patients in the future.
文摘目的探讨在中国肺腺癌患者中,吸烟对组织形态学特征及预后的影响。方法 266例原发性肺腺癌患者按照2011年肺腺癌国际肺癌研究协会/美国胸科学会/欧洲呼吸学会(International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society, IASLC/ATS/ERS)新分类方法进行组织学亚型重新分类,分析吸烟状况等各种临床病理特征与组织学亚型的关系以及对患者术后生存期的影响。结果组织学亚型主要为腺泡状为主型(30.1%)、乳头状为主型(26.7%)、实体状为主型(25.9%)、贴壁状为主型(11.7%)。吸烟状况与组织学亚型有关,实体状为主型患者组中,吸烟患者所占比例高于不吸烟患者,而其它亚型组中则均为不吸烟患者所占比例更高(P<0.05)。Cox比例风险回归模型分析显示,在整体患者中,组织学亚型及TNM分期是术后生存期的预测因子;将患者分为吸烟患者和不吸烟患者,TNM分期在两类患者中均为术后生存期的预测因子,而组织学亚型则只在吸烟患者中显示对预后有显著性影响[标准偏回归系数(B)=0.898,相对危险度(RR)=2.455],与非实体状为主型患者比较,实体状为主患者的预后明显较差。结论吸烟与实体状为主亚型关联,并进一步对预后造成影响。
