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肺腺癌脑转移的诊疗进展

Current status and research progress in the diagnosis and treatment of brain metastases from lung adenocarcinomas

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肺癌是目前已知发病率和病死率最高的恶性肿瘤,而肺癌脑转移是晚期肺腺癌患者中常见的致死性并发症,包括脑实质转移及脑膜转移两种方式.相对于脑实质转移,肺腺癌出现脑膜转移的发生率和临床诊断率都比较低,治疗手段相对受限,效果不佳,自然生存时间较短.单纯依据临床症状、影像学检查及脑脊液细胞学检查诊断,存在漏诊和误诊等情况,可延误患者治疗,而液体活检的出现可大幅提高其早期诊断率.外科手术、化疗、放疗、靶向治疗、抗血管生成治疗及免疫治疗等都可作为肺腺癌脑转移的治疗手段,但对于不同患者,如何选用适合且有效的治疗方案,至今尚无定论.因此,本文就肺腺癌脑转移的诊疗相关研究进展进行综述,以期为肺腺癌脑转移患者寻找最优治疗方案提供理论基础.
Lung cancer is the malignancy with the highest morbidity and mortality,and brain metastasis from lung cancer is a common lethal complication among patients with advanced lung adenocarcinomas,including both parenchymal and leptomeningeal metastases.Compared to those of the former,lung adenocarcinomas present a low incidence and diagnostic rate of leptomeningeal metastases,limited selection of treatment,poor outcomes,and a shorter survival.The diagnosis of brain metastases from lung adenocarcinomas only based on clinical symptoms,imaging and cerebrospinal fluid cytology easily causes underdiagnosis and misdiagnosis,which can delay treatment.Liquid biopsy can significantly improve its early diagnosis rate.Surgery,chemotherapy,radiotherapy,targeted therapy,anti-angiogenic therapy and immunotherapy can all be used to treat brain metastases from lung adenocarcinomas,but a standard guideline for the rational selection of therapeutic strategies is scant.Therefore,this paper reviews the research progress of the treatment of brain metastases from lung adenocarcinomas,thus providing a theoretical basis for selecting the optimal treatment plan for patients with brain metastases from lung adenocarcinomas.

lung adenocarcinomabrain metastasesearly diagnosistreatmentliquid biopsy

武晓旭、张俊萍

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030032 太原市,山西医科大学第三医院(山西白求恩医院 山西医学科学院 同济山西医院)

肺腺癌 脑转移 早期诊断 治疗 液体活检

山西省自然科学基金

201901D111421

2024

河北医药
河北省医学情报研究所

河北医药

CSTPCD
影响因子:1.075
ISSN:1002-7386
年,卷(期):2024.46(5)
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