China Protocol for early screening, precise diagnosis, and individualized treatment of lung cancer.

Journal: Signal transduction and targeted therapy
Published Date:

Abstract

Early screening, diagnosis, and treatment of lung cancer are pivotal in clinical practice since the tumor stage remains the most dominant factor that affects patient survival. Previous initiatives have tried to develop new tools for decision-making of lung cancer. In this study, we proposed the China Protocol, a complete workflow of lung cancer tailored to the Chinese population, which is implemented by steps including early screening by evaluation of risk factors and three-dimensional thin-layer image reconstruction technique for low-dose computed tomography (Tre-LDCT), accurate diagnosis via artificial intelligence (AI) and novel biomarkers, and individualized treatment through non-invasive molecule visualization strategies. The application of this protocol has improved the early diagnosis and 5-year survival rates of lung cancer in China. The proportion of early-stage (stage I) lung cancer has increased from 46.3% to 65.6%, along with a 5-year survival rate of 90.4%. Moreover, especially for stage IA1 lung cancer, the diagnosis rate has improved from 16% to 27.9%; meanwhile, the 5-year survival rate of this group achieved 97.5%. Thus, here we defined stage IA1 lung cancer, which cohort benefits significantly from early diagnosis and treatment, as the "ultra-early stage lung cancer", aiming to provide an intuitive description for more precise management and survival improvement. In the future, we will promote our findings to multicenter remote areas through medical alliances and mobile health services with the desire to move forward the diagnosis and treatment of lung cancer.

Authors

  • Chengdi Wang
    Department of Pulmonary and Critical Care Medicine, Med-X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
  • Bojiang Chen
    Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, West China School of Medicine, Sichuan University, 610041 Chengdu, Sichuan, China.
  • Shufan Liang
    Department of Pulmonary and Critical Care Medicine, Med-X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
  • Jun Shao
    Department of Pulmonary and Critical Care Medicine, Med-X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
  • Jingwei Li
    Department of Pulmonary and Critical Care Medicine, Med-X Center for Manufacturing, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
  • Liuqing Yang
    Department of Anesthesiology, Institute of Anesthesia, Emergency and Critical Care, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, 225002 Yangzhou, Jiangsu, China.
  • Pengwei Ren
    Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Targeted Tracer Research and Development Laboratory, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China.
  • Zhoufeng Wang
    Department of Respiratory and Critical Care Medicine, National Clinical Research Center for Geriatrics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
  • Wenxin Luo
    Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, Targeted Tracer Research and Development Laboratory, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China.
  • Li Zhang
    Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China.
  • Dan Liu
    Department of Bioengineering, Temple University, Philadelphia, PA, United States.
  • Weimin Li
    Department of Psychiatry, Sleep Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, China.