在从未吸烟的人群中,肺癌的威胁日益增加,CT查面临挑战
Jiyoung Song1, Eui Jin Hwang1, Soon Ho Yoon1,2
1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea.
Radiology
|January 27, 2026
概括
从未吸烟者的肺癌 (LCINS) 是一个日益关注的问题,特别是在东亚妇女中. 通过低剂量CT (LDCT) 查进行早期检测需要仔细评估风险,以平衡好处与潜在危害,如过度诊断.
科学领域:
- 在瘤学瘤学.
- 肺部病理学 肺部病理学
- 公共卫生 公共卫生
背景情况:
- 从未吸烟者肺癌 (LCINS) 占病例的10-25%,是癌症死亡的主要原因.
- LCINS在东亚女性中更为普遍,并与二手烟,污染和遗传等因素有关.
- LCINS通常呈现为腺癌,具有特定的驱动突变 (EGFR,ALK,ROS1) 和较低的瘤突变负担.
研究的目的:
- 评估低剂量CT (LDCT) 查从不吸烟者肺癌 (LCINS) 的作用和挑战.
- 讨论与LCINS相关的独特生物特征和风险因素.
- 提出LCINS查和管理的未来方向.
主要方法:
- 对LCINS流行病学,生物学和风险因素的当前文献的综述.
- 对低剂量CT (LDCT) 查LCINS的潜在益处和危害的分析.
- 讨论风险分层和个性化查的新兴策略.
主要成果:
- LDCT查显示了早期LCINS检测的潜力,但引起了人们对过度诊断,过度治疗和辐射暴露的担忧.
- 目前的LDCT查策略对LCINS的死亡率益处尚未被最终证明.
- LCINS表现出明显的分子特征,包括可操作突变的高流行率.
结论:
- 未来的LCINS查必须优先考虑精确的风险分层,优化间隔和危害最小化.
- 对于LCINS管理,需要个性化方法,整合各种数据,可能与人工智能.
- 积极监测可能比立即手术更好,因为惰的,屏幕检测到的LCINS.
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