收稿日期: 2026-05-07
修回日期: 2026-07-16
录用日期: 2026-07-16
网络出版日期: 2026-08-31
Clinical significance and research progress of spread through air spaces （STAS） in non-small cell lung cancer
Received date: 2026-05-07
Revised date: 2026-07-16
Accepted date: 2026-07-16
Online published: 2026-08-31
气道播散（spread through air spaces，STAS）是指肿瘤细胞出现在主瘤边缘之外的肺实质气腔内，是一种新发现的肺癌传播方式。自2015年被世界卫生组织正式定义以来，已彻底重塑了非小细胞肺癌（non-small cell lung cancer，NSCLC）的风险分层与治疗体系。随着JCOG0802（Japan Clinical Oncology Group，日本临床肿瘤学组）/WJOG4607L（West Japan Oncology Group，西日本肿瘤学组）大型临床研究数据的公布，STAS已从单纯的病理学特征，演变为早期NSCLC无复发生存期和总生存期的独立危险因素，是决定外科手术方式（肺叶切除或亚肺叶切除）和术后辅助治疗决策的核心生物标志物。本文将系统性介绍STAS的定义、诊断及术前多模态影像预测模型，阐明基于STAS状态的手术切除范围选择以及辅助治疗的最新循证医学证据，旨在为临床医师规范化诊治提供实践指导。
钟华 , 黄莉棠 , 杜华薇 . 非小细胞肺癌的气道播散临床意义及研究进展[J]. 诊断学理论与实践, 2026 , 25(04) : 399 -405 . DOI: 10.16150/j.1671-2870.2026.04.002
Spread through air spaces (STAS), defined as the presence of tumor cells within the air spaces of the lung parenchyma beyond the edge of the main tumor, represents a novel pattern of invasion in lung cancer. Since its formal definition by the World Health Organization in 2015, STAS has fundamentally reshaped the risk stratification and treatment paradigms for non-small cell lung cancer (NSCLC). With the publication of data from the large-scale JCOG0802/WJOG4607L clinical trials conducted by the Japan Clinical Oncology Group and the West Japan Oncology Group, STAS has evolved from a mere pathological feature into an independent risk factor affecting recurrence-free survival (RFS) and overall survival (OS) in early-stage NSCLC, emerging as a pivotal biomarker for determining the surgical approach (lobectomy or sublobar resection) and postoperative adjuvant therapy decisions. This review systematically outlines the definition, diagnosis, and preoperative multimodal imaging prediction models of STAS. Furthermore, it elucidates the selection of surgical resection extent based on STAS status and presents the latest evidence-based data regarding adjuvant therapy, aiming to provide practical guidance for clinicians in standardizing diagnosis and treatment.
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