由于低剂量螺旋计算机断层扫描的采用增加,越来越多的早期肺癌被诊断为恶性肺结节。但最大尺寸≤3cm的纯实体T1肺癌并不总是处于早期阶段,尽管它的尺寸很小。这种类型的癌症可以是高度侵袭性的,并且与病理相关,转移,术后复发,甚至死亡。然而,在临床上很容易误诊或延误诊断,从而对人类健康构成严重威胁。据报道,T1肺癌中淋巴结或胸腔外转移的百分比>20%。因此,了解和确定纯实体T1肺癌的侵袭性特征对于预防至关重要,诊断,和治疗策略,有利于改善预后。随着肺癌筛查的广泛开展,这些高侵袭性纯实体T1肺癌将成为未来主要的晚期肺癌。然而,关于如何识别这些“早期”侵袭性肺癌的精准医学信息有限。为临床医生提供新的见解,以早期识别和干预高侵袭性纯实体T1肺癌,本文综述了其临床特点,成像,病理学,基因改变,免疫微环境,多组学,以及当前的诊断和预测技术。
A growing number of early-stage lung cancers presenting as malignant pulmonary nodules have been diagnosed because of the increased adoption of low-dose spiral computed tomography. But pure
solid T1 lung cancer with ≤3 cm in the greatest dimension is not always at an early stage, despite its small size. This type of cancer can be highly aggressive and is associated with pathological involvement, metastasis, postoperative relapse, and even death. However, it is easily misdiagnosed or delay diagnosed in clinics and thus poses a serious threat to human health. The percentage of nodal or extrathoracic metastases has been reported to be >20% in T1 lung cancer. As such, understanding and identifying the aggressive characteristics of pure
solid T1 lung cancer is crucial for prevention, diagnosis, and therapeutic strategies, and beneficial to improving the prognosis. With the widespread of lung cancer screening, these highly invasive pure
solid T1 lung cancer will become the main advanced lung cancer in future. However, there is limited information regarding precision medicine on how to identify these \"early-stage\" aggressive lung cancers. To provide clinicians with new insights into early recognition and intervention of the highly invasive pure
solid T1 lung cancer, this review summarizes its clinical characteristics, imaging, pathology, gene alterations, immune microenvironment, multi-omics, and current techniques for diagnosis and prediction.