Professor Zhi Xiuyi: The gains and losses of early screening for lung cancer under the new crown shroud

Mace Medicine: In recent years, under the background of the new crown epidemic, what are the breakthroughs in early screening of lung cancer?

Professor Zhi Xiuyi:

Up to now, the incidence and mortality rate of lung cancer in China are ranked first in malignant tumors, so the state has been working hard to promote the "prevention and screening diagnosis and treatment" of

Since the end of 2019, China has been in the new crown epidemic environment, with the help of new crown pneumonia prevention and control measures, chest CT examination population doubled, millions of lung nodules into our field of vision, lung cancer opportunistic screening ushered in the best opportunity in history, opportunistic screening brought early detection, early lung cancer data also to lung cancer early diagnosis and early treatment work to bring more thinking

First of all, the imaging diagnosis technology of lung cancer is constantly improving with the help of artificial intelligence: from a worldwide perspective, the early screening of lung cancer has gone through more than 50 years of history

In the face of a huge amount of CT image data, the proportion of artificial intelligence technology used is also growing by leaps and bounds, and the clinical value has also been unprecedentedly improved

Liquid biopsy programs and genetic testing programs are also gradually rolling out

All in all, with the maturity and clinical application of the above technologies, the early screening of lung cancer in China has been further improved on the basis of the original, which is conducive to providing early surgical intervention

Metz Medicine:

Metz Medicine: Who are the people suitable for early screening for lung cancer? What are the benefits of the spread of early screening technology for patients, etc.

Professor Zhi Xiuyi:

In the early screening project for determining lung cancer, there has always been a "two highs and one low" statement, that is, in areas with high incidence of lung cancer, lock in the high-risk population of lung cancer, such as those who are over 50 years old, have a smoking index of more than 400, have a family history of tumors, especially a family history of lung cancer, have previously suffered from lung diseases, have environmental and occupational exposure factors, etc.

Through the screening of early lung cancer, thoracic surgeons can also perform surgical intervention in a timely manner, so that early lung cancer, especially early stage A lung cancer, can achieve clinical cure

Mace Medicine: As you said above, in the early screening process of lung cancer, many people with small lung nodules will be screened out, and at present, there will still be some young doctors who do not have a deep understanding of the difference between small lung nodules and lung cancer.

Professor Zhi Xiuyi:

With the extensive use of chest CT since the COVID-19 pandemic, tens of millions of small lung nodules have now been "discovered" and "diagnosed.

First of all, we need to clarify the fact that the vast majority of small pulmonary nodules may have been in people's bodies for years, years, ten years or even longer before they were found by chest CT, and it was only because of the screening of the new crown epidemic that they were "discovered"

The reality is that excessive clinical intervention will undoubtedly cause excessive panic

The first is for the population of small lung nodules, we must do a good job of science education, to avoid excessive panic

Secondly, in the face of a huge image sample size, clinicians should make good use of artificial intelligence technology on the one hand to make rapid and preliminary judgments

Metz Medicine: Finally, the current discussion about precision treatment of lung cancer is very hot, can you please share your insights?

Professor Zhi Xiuyi:

The field of lung cancer has long been talking about the concept

Precision treatment generally refers to some of our new technologies and drugs
in recent years.
For example, in recent years, we have applied artificial intelligence technology and molecular marker detection projects on a large scale to conduct multi-dimensional assessments
.
For suspected early lung cancer or early lung cancer, we will be divided into wedge resection, lung segment resection and lobate resection according to the size of the lesion and the location of the lesion
.
With the continuous development of high technology, compared with the previous open chest surgery hand to touch the nodule for positioning, the current artificial intelligence system can be accurately positioned before surgery, thereby guiding the precise resection
during surgery.

Of course, when it comes to the precise treatment of lung cancer, molecularly targeted drug therapy is an unavoidable topic
.
Although there are currently many targeted drugs according to different gene mutations, and are gradually being included in medical insurance, the genetic testing project to detect what kind of gene mutation of patients is still being "turned away" by the medical insurance departments of most provinces and cities, which will lead to many patients disagreeing with the genetic testing suggestions put forward by doctors due to price factors, and blindly using targeted drugs to treat without genetic testing, which not only wastes the medical resources of both doctors and patients, but also easily delays the best
。

Finally, the meaning of precision treatment should not be limited to the treatment itself, we also need to take into account the local health insurance policy and the actual economic situation of patients, and do not let patients become poor due to illness and return to poverty
due to illness.