"Liquid biopsy" technique combined with low dose CT: open window for early diagnosis of lung cancer

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Lung cancer is one of the most common malignant tumors all over the world. In some major cities in China, lung cancer has become the most co


Lung cancer is one of the most common malignant tumors all over the world. In some major cities in China, lung cancer has become the most common malignant tumor in male adults. Early diagnosis and early treatment is the only way to reduce the mortality of lung cancer and improve the long-term survival rate of patients with lung cancer. At present, many patients because of persistent cough, hemoptysis and chest pain and other symptoms to the hospital, through routine chest X-ray examination found that the majority of tumors had been advanced by surgery, radiotherapy, chemotherapy, or biological treatment, 5 year survival rate is low. Therefore, for the early stage of lung cancer, especially in the peripheral part of the lung small tumors, often without symptoms, must be through the health census method is likely to be found in a timely manner. The traditional examination method is the chest X-ray examination, easily missed diagnosis, the main reason is: the small peripheral lung cancer lesions and surrounding lung tissue contrast; the chest radiography, lung and mediastinum, heart and diaphragm overlap. Compared with low dose CT thin layer can pass through the high-speed data acquisition, continuous, and cross-sectional imaging, can be found in dead or missing small lesions due to chest anatomy structure of overlapping causes, significantly improve the small pulmonary nodules detection ability is of great significance to the early detection of lung cancer. But the conventional chest spiral CT examination when the radiation dose is large, as if the "healthy people" lung cancer screening, radiological examination does not conform to the principle of optimization, therefore, low dose scanning is more in line with the requirements of health examination.

Low dose CT is a CT technique based on the minimum scanning range and radiation concentration that can detect the small nodules in the lung. Many people have a misunderstanding that the CT scan of the X-ray radiation will cause harm to the human body, and often do not want to low-dose spiral CT examination. In fact, the conventional CT examination because X-ray radiation dose was higher, 60~100 times of chest X-ray CT radiation dose equivalent to X-ray dose; and low dose CT scanning method by reducing the tube current and tube voltage, through the thin slice reconstruction, highlighting its fast scanning speed, low dose, high detection rate, scanning radiation the dose was significantly lower than that of conventional CT. Foreign studies have shown that low dose CT in the detection and diagnosis of pulmonary nodules has the same ability as the conventional dose CT scan. In the middle of the 90s, several universities and research institutions in Japan and the United States began to study the application of low-dose CT. The results showed that low-dose CT scan could detect more lung cancer, especially early lung cancer.

"Low dose" is a way of checking, a new concept, not a new technology! Spiral CT at present Shanghai district two or three hospitals already have various types and specifications, using conventional dose 10%-30% (low dose) can obtain chest images of high quality, enough for lung cancer screening, greatly reduce the radiation dose. The detection rate of small lung cancer and early lung cancer was less than 80%, which was less than 1cm in the low dose of CT. In the early stage of lung cancer screening, 80% to 90% can be cured by minimally invasive surgery without further radiotherapy and chemotherapy. Therefore, the domestic and foreign medical experts suggest that for people at high risk for lung cancer and the condition of the area, units or individuals, should be actively carried out regularly every year for a low dose chest CT examination, improve the level of clinical diagnosis and treatment of early lung cancer.

Early detection of cancer through a drop of blood is a common dream and research goal of the global medical community for decades. The blood detection of cancer (liquid biopsy) has a variety of uses, and plays an important role in various aspects of tumor disease monitoring, personalized medicine, early diagnosis of cancer. "Liquid biopsy" idea and technology promotion has 15 years of history, cancer screening used in high-risk groups and high-risk areas, can help to more accurately detect early cancers, greatly reducing "excessive treatment", to provide more clinical information for clinical reference. Lung cancer, small nodules by low dose CT thin layer found in the future, especially the sub centimeter nodules (less than 1 cm in diameter), if combined with a "liquid biopsy" techniques to clinical pulmonary nodules risk stratification and clinical intervention treatment decisions provide important reference information, which brings great blessings to the broad masses of patients.

In November 2015 Chinese state food and Drug Administration (CFDA) has approved seven kinds of lung cancer antibody products in the domestic market, this is the first CFDA approved for identification of benign and malignant lung nodules diagnosis and early lung cancer detection of blood. I believe in the near future, the hospital will gradually carry out the testing business.

Note: lung cancer in high-risk areas: more than 50 years of age, smoking index in more than 400 years (number of years of smoking per day multiplied by the number of smoking and secondhand smoke) for more than 20 years, long-term work in a confined environment or long-term work in the environment with more dust particles in the above conditions with any two then, should be regularly checked, the early detection of the disease.


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