吸烟或成为预测肺癌幸存者癌症复发的主要预测器

  据估计在2015年将有158040个美国人因患肺癌而死亡，这无疑或使得肺癌在美国成为引发人们死亡的主要原因；对高风险吸烟人群利用低剂量的CT扫描进行肺癌筛查最近被批准用于检测早期没有显著症状的肺癌患者，而研究者希望可以通过进行早期的肺癌诊断筛查来帮助医生进行更多的治疗选择，从而为改善患者的预后提供希望。
  近日，在2015年美国胸科协会国际会议上，研究者表示，许多肺癌幸存者患其它类型肺癌的风险较高，或者在完成治疗后肺癌复发的风险较高，研究人员主要对三种不同体系的肺癌幸存者进行了研究，并没有证据显示这些患者在进行肺癌治疗后会疾病复发。
  研究者Samjot Dhillon博士表示，我们密切观察了一些风险因素，因为其或可帮助我们预测肺癌幸存者的癌症复发风险；有肺癌史的病人应当进行长期的监督观察以便医生们可以在患者肺癌复发的早期进行及时的诊断和疗法处理。研究者对192名肺癌幸存者进行观察研究，对患者利用CT扫描胸腔及萤光气管镜进行了平均约8.5年的病情跟踪监测，CT扫描可以揭示患者机体胸腔中较大的淋巴结或者由癌症在肺部引发的根瘤，而萤光气管镜则可以帮助医生观察到中心气管中的恶化前及早期恶性的机体损伤；这两种技术都可以帮助个体进行早期的肺癌诊断。
  同时研究人员还分析了其它主要的风险因素以便他们可以阐明这些风险因素和癌症复发之间的关联，这些风险因素包括：吸烟状态、先前的癌症、呼吸道疾病等；研究者表示，在研究期间有38%的患者都被发现癌症复发或者患上了其它类型的肺癌；而后期研究中研究人员还将分析其它主要的风险因子来帮助预测患者肺癌的复发风险。
  针对肺癌复发不光要进行密切的医疗监护，对患者而言停止吸烟及其它可能性的风险也对预防肺癌复发非常关键；每年因吸烟往往会增加许多患者的肺癌复发。（转化医学网360zhyx.com）
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Smoking a significant predictor of lung cancer recurrence in survivors

A new study has shown that many lung cancer survivors are at high risk for developing another lung cancer or having their cancer return after completing treatment. Conducted by researchers in the U.S., the study specifically looked at lung cancer survivors from three different institutions who had shown no further evidence of having the disease after completing the required treatment for lung cancer.

The study will be presented at the ATS 2015 International Conference.

"We looked closely at risk factors that may help in predicting cancer recurrence in lung cancer survivors," said study lead author Samjot Dhillon, MD. "What we learned is that patients with a history of lung cancer should have close long-term surveillance so their doctor can detect early on if the cancer is recurring or if there is another cancer developing."

The research looked at 192 lung cancer survivors who underwent surveillance with CT scans of their chest and autofluorescence bronchoscopy (AFB) for a mean duration of close to 8 and a half years. AFB allows doctors to see premalignant and early malignant lesions in the central airways while CT scans can reveal large lymph nodes in the chest or nodules inside the lungs which could be due to cancer. This means both CT and AFB may allow detection of lung cancer in early stages.

They also looked at information about major risk factors to see if there was a connection between them and cancer recurrence. Those factors included: smoking status, as well as how many packs they smoke per year; prior cancers; respiratory disease; asbestos exposure; and if there was a family history of lung cancer.

What they found was that 38% had developed recurrent or another lung cancer during this period. Further research analyzing the significant factors for predicting lung cancer recurrence indicated that those factors were: having recurrence of another non-lung cancer; presence of a nodule on a CT scan of chest, regardless of its size or location; finding premalignant lesions called "metaplasia" on three AFB exams anywhere in central airway; and how long the patients had been smoking. In fact, for every additional pack a patient smoked per year, it increased the risk of having lung cancer again by 1%.

This study demonstrates that lung cancer survivors need to be monitored closely by their doctors to detect if their lung cancer is recurring or if another is developing.

"Along with close medical surveillance for lung cancer recurrence, it is also important for patients to stop smoking as soon as possible since this is a known risk," said Dhillon. "Every additional pack per year of smoking is associated with further increased risk of cancer recurrence."