期刊
CANCER TREATMENT REVIEWS
卷 58, 期 -, 页码 77-90出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.ctrv.2017.05.009
关键词
Preinvasive disease; Squamous cell carcinoma; Lung cancer; Carcinoma in situ; Autofluorescence bronchoscopy; Bronchoscopic treatment
类别
资金
- Roy Castle Lung Cancer Foundation
- Rosetrees Trust
- Welton Trust
- Garfield Weston Trust
- UCLH Charitable Foundation
- Medical Research Council [G108/596] Funding Source: researchfish
- National Institute for Health Research [ACF-2015-18-004] Funding Source: researchfish
- Rosetrees Trust [M35-F1-CD1, M35-F2, M510-CD1] Funding Source: researchfish
- Wellcome Trust [107963/Z/15/Z] Funding Source: researchfish
- MRC [G108/596] Funding Source: UKRI
- Wellcome Trust [107963/Z/15/Z] Funding Source: Wellcome Trust
Squamous cell carcinoma of the lung arises from preinvasive progenitors in the central airways. The archetypal model appears to be a stepwise morphological progression until there is invasion of the basement membrane. However, not every lesion appears to follow this course and many individuals can have stable disease, or indeed regress to normal epithelium. From our increased understanding of the molecular pathology it is becoming apparent that the respiratory epithelium accumulates progressive genetic and epigenetic insults in response to carcinogens. Still, little is known about how to predict those 'at risk' of progression, and it is likely that in the future molecular signatures will underpin prediction models of developing invasive lung cancer. Currently, autofluorescence bronchoscopy gives us the ability to follow the natural history of these lesions, with the prospect that detecting and treating lesions early may improve survival. However, treatment remains controversial, and radical therapies are offered to individuals with carcinoma in situ who may never develop invasive cancer. This has paved the way for the use of minimally invasive bronchoscopic treatments, which, while apparently effective, have not been tested in randomised controlled trials. In this paper we describe the known biology and natural history of preinvasive lesions and review the current treatment strategies. (C) 2017 Elsevier Ltd. All rights reserved.
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