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在个体化治疗来临时代,对存在驱动基因的晚期非小细胞肺癌(NSCLC)患者,靶向药物已成为目前的治疗趋势。而对于基因类型未明或野生型的患者,根据其病理类型指导治疗已是非小细胞肺癌治疗的共识。但在临床工作中,仍存在一群病理类型不确定的非小细胞肺癌(NSCLC-NOS)患者。NSCLC-NOS的诊断主要依靠形态学诊断及免疫组织化学染色方法。免疫组织化学染色方法的准确率相对较高,对NSCLC的分型更精确。关于NSCLC-NOS,目前靶向治疗的数据较少。对于NSCLC-NOS一线化疗方案研究较少,大多数试验在与其他病理类型的比较中,PFS及OS并不具有统计学意义。部分试验取得了PFS或OS数据上的获益,但均因样本量较小而无统计学差异。NSCLC-NOS是肺癌预后的独立不良因素。相较于其他病理类型的肺癌,NSCLC-NOS更具侵袭性。
In the advent of personalized medicine, targeted drugs have become the current therapeutic trend for patients with advanced non-small cell lung cancer (NSCLC) with driver genes. However, for patients with unknown genotype or wild type, directing treatment according to their pathological type has been the consensus of non-small cell lung cancer therapy. However, in clinical work, there are still a group of patients with non-small cell lung cancer (NSCLC-NOS) of uncertain pathological type. The diagnosis of NSCLC-NOS relies mainly on morphological diagnosis and immunohistochemical staining. The accuracy of immunohistochemical staining is relatively high, and the typing of NSCLC is more accurate. With regard to NSCLC-NOS, there is currently less data on targeted therapy. For NSCLC-NOS first-line chemotherapy less research, most of the tests in the comparison with other pathological types, PFS and OS does not have statistical significance. Some trials have gained PFS or OS data on the benefits, but due to the smaller sample size without statistical differences. NSCLC-NOS is an independent adverse prognostic factor for lung cancer. NSCLC-NOS is more aggressive than other pathological types of lung cancer.