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中华胸部外科电子杂志 ›› 2026, Vol. 13 ›› Issue (02) : 132 -139. doi: 10.3877/cma.j.issn.2095-8773.2026.02.06

综述

ⅠA3期非小细胞肺癌预后差异及治疗策略研究进展
余绍斌1,2,3, 康明强1,2,3,()   
  1. 1350001 福州,福建医科大学附属协和医院胸外科
    2350122 福州,福建医科大学基础医学院消化道恶性肿瘤教育部重点实验室
    3350001 福州,福建医科大学附属协和医院福建省胸心外科重点实验室
  • 收稿日期:2025-11-24 修回日期:2026-01-05 接受日期:2026-02-28 出版日期:2026-05-28
  • 通信作者: 康明强
  • 基金资助:
    福建省自然科学基金(2023J01098)

Research progress in prognostic heterogeneity and treatment strategies for stage ⅠA3 non-small cell lung cancer

Shaobin Yu1,2,3, Mingqiang Kang1,2,3,()   

  1. 1Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China
    2Key Laboratory of Gastrointestinal Cancer, Ministry of Education, School of Basic Medical Science, Fujian Medical University, Fuzhou 350122, China
    3Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou 350001, China
  • Received:2025-11-24 Revised:2026-01-05 Accepted:2026-02-28 Published:2026-05-28
  • Corresponding author: Mingqiang Kang
引用本文:

余绍斌, 康明强. ⅠA3期非小细胞肺癌预后差异及治疗策略研究进展[J/OL]. 中华胸部外科电子杂志, 2026, 13(02): 132-139.

Shaobin Yu, Mingqiang Kang. Research progress in prognostic heterogeneity and treatment strategies for stage ⅠA3 non-small cell lung cancer[J/OL]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2026, 13(02): 132-139.

ⅠA3期非小细胞肺癌(NSCLC)作为早期肺癌中的"高危亚组",其预后异质性显著,治疗策略存在诸多争议。本文系统综述ⅠA3期NSCLC的预后特征及其驱动因素,重点探讨气腔播散(STAS)、淋巴血管侵犯(LVI)、肿瘤间质比(TSR)等高危病理标志物在预后分层中的作用,并分析其在手术范围选择(肺叶切除与亚肺叶切除)及辅助治疗决策中的临床意义。本文结合现有循证医学证据,提出基于多模态风险模型的个体化治疗策略,旨在为临床实践提供指导,推动ⅠA3期NSCLC从"解剖分期"向"生物学行为驱动"的精准管理转型。

Stage ⅠA3 non-small cell lung cancer (NSCLC) represents a high-risk subgroup within early-stage lung cancer, characterized by significant prognostic heterogeneity and ongoing controversies in treatment strategies. This review systematically summarizes the prognostic features and driving factors of stage ⅠA3 NSCLC, with a focus on high-risk pathological markers such as spread through air spaces (STAS), lymphovascular invasion (LVI), and tumor-stroma ratio (TSR), and their roles in prognostic stratification. We further analyze their clinical implications in surgical extent selection and adjuvant therapy decision-making. By integrating advanced technologies such as radiomics and artificial intelligence, we discuss recent advances in preoperative prediction and postoperative personalized adjuvant therapy. We propose a precision treatment strategy based on multimodal risk models, aiming to provide evidence-based guidance for clinical practice and facilitate the transition from anatomic staging to biology-driven individualized management for stage IA3 NSCLC.

表1 ⅠA3期与ⅠA1/ⅠA2期、ⅠB期预后指标对比
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