[Analysis of treatment failure phenotype and prognostic factors of stage Ⅰ non-small cell lung cancer].

Non-small cell lung cancer (NSCLC) is one of the most severe malignant tumors worldwide. Lobectomy and systematic nodal dissection remain the standard treatment for stageⅠNSCLC. Stereotactic body radiotherapy (SBRT) has become the standard treatment for medically inoperable patients. Though the prognosis of stage Ⅰ NSCLC patients is generally good, there are still about 20% of patients with local recurrence and distant metastasis. There is significant heterogeneity in the prognosis and failure phenotype of patients, which cannot be precisely distinguished by the pathological TNM classification system. Identification of the risk factors for the prognosis of patients with stage Ⅰ NSCLC is a key step to realize the treatment from experience to precision. Screening the high-risk patients will facilitate to individually develop the adjuvant therapy strategy after surgery or SBRT and improve the overall curative effect. There are many factors that are significantly related to the prognosis of stage Ⅰ NSCLC including individual factors such as gender, age, and systemic inflammatory biomarkers; treatment-related factors such as the extent of surgical resection of the primary tumor and lymph nodes, the choice of different radiation rays, and different dose fractionation; and tumor-related factors such as imaging information, pathology information; and molecular biology information. This review will analyze the treatment failure phenotype and prognostic factors of stageⅠ NSCLC in various perspectives such as individual-, tumor- and treatment-related factors.非小细胞肺癌(NSCLC)是严重危害人类健康的常见恶性肿瘤，Ⅰ期NSCLC的主要治疗方式为肺叶切除联合系统性淋巴结清扫，不能耐受或拒绝手术的患者也可采用立体定向放射治疗(SBRT)。虽然Ⅰ期NSCLC患者预后整体较好，但仍有约20%的患者会出现局部复发及远处转移。患者的预后和失败表型存在异质性，无法被病理TNM分期所精准预测。寻找影响I期NSCLC患者预后的危险因素是实现其治疗由经验到精准的关键一步。准确预测高危患者，可以为制定手术后或SBRT后个体化辅助治疗策略提供指导，进而提高Ⅰ期NSCLC的总体疗效。患者的个体相关因素如性别、年龄、全身免疫炎症指标，治疗相关因素如手术切除原发灶及淋巴结范围、不同放射线的选择及不同剂量分割模式，肿瘤相关因素如肿瘤影像学信息、病理学信息及分子生物学信息均与Ⅰ期NSCLC的预后有关。文章将从宿主、肿瘤及治疗相关因素等多方面对Ⅰ期NSCLC治疗失败表型及预后预测的研究进展进行综述。.