原发性多发肺结节“炎癌转化”机制探讨

李梦乾; 张晓梅; 姜良铎; 赖宇鑫

doi:10.3969/j.issn.1006-2157.2024.10.004

您当前的位置：

首页 >

文章列表页 >

原发性多发肺结节“炎癌转化”机制探讨

“中医药防治‘炎癌转化’”专题 | 更新时间：2024-10-29

- 原发性多发肺结节“炎癌转化”机制探讨
  增强出版
- Discussion on the mechanism of the " inflammation-cancer transformation" in primary multiple pulmonary nodules
- 北京中医药大学学报 2024年47卷第10期页码：1355-1359
- 作者机构：
  
  1.北京中医药大学东方医院　北京　100078
  2.北京中医药大学东直门医院
- 作者简介：
  
  李梦乾，女，在读博士生
  #张晓梅，女，博士，教授，主任医师，博士生导师，主要研究方向：中医药防治呼吸系统疾病，E-mail：Zhangxim6767@sina.com
- 基金信息：
  
  首都卫生发展科研专项(2020-2-4202);北京中医药大学2024年基本科研业务费“揭榜挂帅”项目(2024-JYB-JBZD-009)
- DOI：10.3969/j.issn.1006-2157.2024.10.004
  中图分类号： R256.1
- 收稿：2024-07-04，
  
  网络首发：2024-08-21，
  
  纸质出版：2024-10-30
- 稿件说明：
移动端阅览
李梦乾, 张晓梅, 姜良铎, 等. 原发性多发肺结节“炎癌转化”机制探讨[J]. 北京中医药大学学报, 2024,47(10):1355-1359.

LI Mengqian, ZHANG Xiaomei, JIANG Liangduo, et al. Discussion on the mechanism of the " inflammation-cancer transformation" in primary multiple pulmonary nodules[J]. Journal of Beijing University of Traditional Chinese Medicine, 2024, 47(10): 1355-1359.
李梦乾, 张晓梅, 姜良铎, 等. 原发性多发肺结节“炎癌转化”机制探讨[J]. 北京中医药大学学报, 2024,47(10):1355-1359. DOI： 10.3969/j.issn.1006-2157.2024.10.004.

LI Mengqian, ZHANG Xiaomei, JIANG Liangduo, et al. Discussion on the mechanism of the " inflammation-cancer transformation" in primary multiple pulmonary nodules[J]. Journal of Beijing University of Traditional Chinese Medicine, 2024, 47(10): 1355-1359. DOI： 10.3969/j.issn.1006-2157.2024.10.004.

摘要

原发性多发肺结节发病率较高。计算机断层成像观察中发现，随时间推移，肺结节会出现增大增多的变化。术后的病理学检查结果包括慢性炎症、腺瘤样改变、原位癌、微浸润癌、浸润癌等多种病理形态。随着病程的延长和外界因素的刺激，多发肺结节存在“炎癌转化”的可能性。湿痰瘀停聚是“炎癌转化”的基础，正气亏耗是“炎癌转化”的关键，气虚阳虚为正气亏耗的根本，情志郁结、湿痰瘀化毒为“炎癌转化”的动力。“炎癌转化”过程中存在正邪交争、湿痰瘀消长，邪长正消，湿痰瘀停聚增多、正气亏耗则结节增大增多、恶性度增加，呈现出炎→不典型性增生→癌的动态过程；正长邪消、湿痰瘀消散吸收则结节消退、癌变进程逆转，急性炎症刺激等外界激惹可加速多发肺结节“炎癌转化”进程。

Abstract

Primary multiple pulmonary nodules have a high incidence

and the size and number of pulmonary nodules on computed tomography images increase with time. Postoperative pathology of multiple pulmonary nodules shows chronic inflammation

adenomatoid change

carcinoma in situ

microinvasive carcinoma

infiltrating carcinoma

and other forms. There is a possibility of " inflammation-cancer transformation" in multiple pulmonary nodules with prolonged time and external irritation. The accumulation of dampness phlegm and blood stasis is the basis of the theory of " inflammation-cancer transformation." Healthy qi deficiency is the key to the " inflammation-cancer transformation." Qi and yang deficiency are the root cause of healthy qi depletion. Emotional depression

dampness

phlegm

and blood stasis transforming into toxins provide the impetus for " inflammation-cancer transformation." There are struggle between healthy qi and evil qi

and waxing and waning of dampness

phlegm and blood stasis in the process of " inflammation-cancer transformation." The dampness phlegm and blood stasis will increase when evil qi increases and healthy qi decreases. In contrast

the size

number

and malignancy of nodules will increase during healthy qi deficiency

showing a dynamic shift from inflammation to atypical adenomatous hyperplasia to cancer. The dampness phlegm and blood stasis will be absorbed as the healthy qi increases and evil qi decreases so that lung cancer can be reversed. External irritation

such as acute inflammatory stimulation

may accelerate the transformation of " inflammation-cancer" in multiple pulmonary nodules.

关键词

Keywords

references

中国中西医结合学会，肿瘤专业委员会，北京中医药学会，等 . 肺结节中西医结合全程管理专家共识 [J ] . 中国实验方剂学杂志， 2024 , 30 ( 1 ): 149 - 159 .

WANG X , WU MQ , SHEN HF , et al . Comparison of clinical and pathological characteristics between extremely multiple GGNs and single GGNs [J ] . Front Oncol , 2021 , 11 : 725475 .

ZHANG Y , JHEON S , LI HM , et al . Results of low-dose computed tomography as a regular health examination among Chinese hospital employees [J ] . J Thorac Cardiovasc Surg , 2020 , 160 ( 3 ): 824 - 831 .

刘广杰，巨建梅，张静静，等 . 肺部同时性多发磨玻璃结节56例临床分析 [J ] . 临床肿瘤学杂志， 2020 , 25 ( 5 ): 456 - 460 .

中华医学会呼吸病学分会肺癌学组，中国肺癌防治联盟专家组 . 肺结节诊治中国专家共识(2018年版) [J ] . 中华结核和呼吸杂志， 2018 , 41 ( 10 ): 763 - 771 .

史文松，胡玉缀，王慧，等 . 肺原位腺癌手术与随访之争议解析 [J ] . 医学与哲学， 2022 , 43 ( 10 ): 59 - 63 .

CANDIDO J , HAGEMANN T . Cancer-related inflammation [J ] . J Clin Immunol , 2013 , 33 ( Suppl 1 ): S79 - S84 .

丁霞，李园，沈洪 . 从精准医学的视角看中医药防治慢性胃炎“炎癌转化” [J ] . 北京中医药大学学报， 2023 , 46 ( 3 ): 315 - 320 .

LI D , ZHANG DL , WANG MJ , et al . Pro-inflammatory diet as a risk factor for stomach cancer: findings from a multicenter study in central and western China [J ] . J Multidiscip Healthc , 2024 , 17 : 901 - 912 .

OHNO T , KIKUCHI T , SUZUKI Y , et al . Periodontitis promotes hepatocellular carcinoma in Stelic Animal model (STAM) mice [J ] . Sci Rep , 2024 , 14 ( 1 ): 17560 .

邵高眩，孙陈岑，季光，等 . 基于LPL/CPT1/FABP4通路探讨健脾化痰方对非酒精性脂肪性肝病“炎癌转化”的抑制作用 [J ] . 北京中医药大学学报， 2023 , 46 ( 12 ): 1706 - 1715 .

王瑞龙，吴金峰．衰老、慢性炎症与皮肤肿瘤 [J ] . 老年医学与保健， 2023 ， 29 ( 6 )： 1109 - 1113 .

PRETI M , BORELLA F , FERRETTI S , et al . Genital and extragenital oncological risk in women with vulvar lichen sclerosus: a multi-center Italian study [J ] . Maturitas , 2023 , 175 : 107767 .

WALTER K . Pulmonary nodules [J ] . JAMA , 2021 , 326 ( 15 ): 1544 .

张传龙，姜晓晨，庞博，等 . 基于“热极成毒”理论探讨肺“炎-癌转化”与防治思路 [J ] . 北京中医药大学学报， 2022 , 45 ( 3 ): 291 - 295 .

LI WJ , LYU FJ , TAN YW , et al . Pulmonary benign ground-glass nodules: CT features and pathological findings [J ] . Int J Gen Med , 2021 , 14 : 581 - 590 .

王凤华，樊鹏鹏，朱庆华．肿瘤标志物联合细胞因子对高危人群及肺结节肺癌早期诊断的价值 [J ] . 中国卫生检验杂志， 2022 ， 32 ( 22 )： 2772 - 2776 .

GHOSN M , ELSAKKA AS , PETRE EN , et al . Induction and preliminary characterization of neoplastic pulmonary nodules in a transgenic pig model [J ] . Lung Cancer , 2023 , 178 : 157 - 165 .

李园，赵莹，陈萌，等 . 从中医学视角探讨慢性胃炎“炎癌转化”过程的免疫失衡与重建 [J ] . 北京中医药大学学报， 2021 , 44 ( 1 ): 92 - 96 .

LEE JH , HWANG EJ , LIM WH , et al . Determination of the optimum definition of growth evaluation for indeterminate pulmonary nodules detected in lung cancer screening [J ] . PLoS One , 2022 , 17 ( 9 ): e0274583 .

WANG B , ZHANG H , LI W , et al . Neural network-based model for evaluating inert nodules and volume doubling time in T1 lung adenocarcinoma: a nested case-control study [J ] . Front Oncol , 2023 , 13 : 1037052 .

WALTER JE , HEUVELMANS MA , DE JONG PA , et al . Occurrence and lung cancer probability of new solid nodules at incidence screening with low-dose CT: analysis of data from the randomised, controlled NELSON trial [J ] . Lancet Oncol , 2016 , 17 ( 7 ): 907 - 916 .

HENDRIX W , RUTTEN M , HENDRIX N , et al . Trends in the incidence of pulmonary nodules in chest computed tomography: 10-year results from two Dutch hospitals [J ] . Eur Radiol , 2023 , 33 ( 11 ): 8279 - 8288 .

何慧，杨亚茹，姜立美，等 . 亚实性肺结节CT动态随访与影响后续生长的危险因素分析 [J ] . 肿瘤影像学， 2022 , 31 ( 1 ): 74 - 80 .

晏睿滢，李华秀，丁莹莹，等 . 孤立性肺结节良恶性预测模型的建立及验证 [J ] . 放射学实践， 2020 , 35 ( 3 ): 352 - 359 .

李梦乾，张晓梅，胡家蕊，等．孤立性肺结节良恶性预测模型的系统评价 [J ] . 肿瘤预防与治疗， 2022 ， 35 ( 4 )： 318 - 328 .

VASILE C . Mental health and immunity (Review) [J ] . Exp Ther Med , 2020 , 20 ( 6 ): 211 .

李思敏，张晓梅，李梦乾，等 . 260例肺结节患者抑郁焦虑状态、睡眠质量的相关研究 [J ] . 中华中医药杂志， 2022 ， 37 ( 11 )： 6667 - 6670 .

胡家蕊，张晓梅，李梦乾，等 . 肺结节340例患者中医体质状态临床调查分析 [J ] . 中华中医药杂志， 2023 , 38 ( 10 ): 4996 - 4999 .

浏览量

886

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

基于“态靶因果”探析慢性胰腺炎“炎癌转化”的病机演变与论治策略

基于中医体质学基本原理探讨儿童过敏性紫癜的精准防治

基于阴火理论探讨恶性肿瘤“炎癌转化”机制及防治思路

中西医结合防治胃“炎癌转化”的研究及创新探索

从“两节点-三阶段”探讨巴雷特食管炎癌转化的病机演变与中医截断策略