晚期非小细胞肺癌免疫治疗与消融治疗的研究进展

肺癌为原发性支气管肺癌的简称，是起源于气管、支气管黏膜或腺体的最常见的肺部原发性恶性肿瘤。根据组织病理学特点分为非小细胞肺癌（non-small cell lung cancer，NSCLC）和小细胞肺癌。其中，NSCLC又包括鳞癌和腺癌。肺癌发病率高，早诊率低，预后较差。2018年全球统计数据显示，肺癌发病率高居所有癌症发病率的第一位（总病例数的11.6%），是导致癌症死亡的主要原因（占癌症总死亡人数的18.4%）。高达55%的NSCLC患者诊断时已处于Ⅳ期，无法手术。目前全身治疗仍然是晚期NSCLC的主要治疗方式，免疫治疗俨然成为全身治疗中最重要的一环。但是越来越多的证据表明，对原发肿瘤部位进行局部消融治疗同样可以提高生存率，激活全身免疫系统，助力免疫治疗。自然而然，个体化微创消融治疗结合免疫治疗就成为了一种新兴的治疗策略。本文综述了NSCLC的免疫治疗、消融治疗以及两种方式联合治疗的研究进展。

Advances in immunotherapy and ablative therapy for advanced NSCLC

Lung cancer is the abbreviation of primary bronchial lung cancer,which is the most common primary malignant tumor of the lung originating from the trachea,bronchial mucosa or glands.Non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) are divided according to histopathological characteristics.Among them,NSCLC includes squamous cell carcinoma and adenocarcinoma.Lung cancer has high incidence rate,low early diagnosis rate and poor prognosis.Global statistics in 2018 show that lung cancer incidence ranks the first among all cancers (11.6% of total cases) and is the main cause of cancer deaths (18.4% of total cancer deaths).Up to 55% of NSCLC patients have been diagnosed as stage Ⅳ and cannot be operated on.At present,systemic therapy is still the main treatment for advanced NSCLC and immunotherapy has become the most important part of systemic therapy.But there is growing evidence that local ablation of the primary tumor site can also improve survival rate and activate the immune system to enhance immunotherapy.Therefore,individualized minimally invasive ablation combined with immunotherapy has become a new treatment strategy.This paper reviews the research progress of immunotherapy,ablation therapy and combination of these two therapies of NSCLC.