摘要
脏层胸膜侵犯(visceral pleural invasion, VPI)是非小细胞肺癌(non-small cell lung cancer, NSCLC)的预后不良因素。据报道PL0 (肿瘤位于胸膜下肺实质内或侵犯胸膜弹性层下的胸膜连接组织)肿瘤患者的5年总生存率,显著高于PL1 (肿瘤侵犯超过脏层胸膜弹性层)肿瘤患者及PL2 (肿瘤侵及脏层胸膜表面)肿瘤患者,(75.9%) VS (63.6%) (54.1%)。因此准确诊断及积极治疗VPI对改善NSCLC患者的预后有重要意义。目前临床上可以通过B超、CT检查等方法进行较好的预测,组织学诊断成为VPI诊断的金标准。年龄、性别、淋巴结转移、病理类型、EGFR (+)被认为与VPI的发生具有相关性,可以作为NSCLC患者发生VPI的风险因素。肺叶切除术加系统淋巴结清扫术是I期NSCLC患者的标准治疗方法,但I期NSCLC患者是否需要进行辅助化疗尚存有争议。本文就VPI诊断、临床病理特征及治疗的研究现状作一综述。
Visceral pleural invasion (VPI) was found to be a poor prognostic factor for NSCLC. It was reported that the 5-year overall survival rate of patients with PL0 (tumor without pleural involvement be-yond its elastic layer) tumor (75.9%) was significantly higher than that of patients with PL1 (tumor that invades beyond the elastic layer) tumor (63.6%) and PL2 (tumor that invades to the pleural surface) tumor (54.1%). Therefore, accurate diagnosis and active treatment of VPI are of significance to improving the prognosis of patients with NSCLC. At present, B-ultrasound, CT ex-amination and other methods can be used in clinical prediction, histological diagnosis is the gold standard of VPI diagnosis. Age, gender, lymph node metastasis, pathological type and EGFR (+) are considered to be correlated with the occurrence of VPI and can be used as risk factors for the oc-currence of VPI in NSCLC patients. Lobectomy plus systematic lymph node dissection is the standard treatment for patients with stage I NSCLC, but the need for adjuvant chemotherapy is controversial. This article reviews the current status of diagnosis, clinicopathological features and treatment of VPI.
出处
《临床医学进展》
2022年第12期12115-12122,共8页
Advances in Clinical Medicine
