近些年来,随着精准医学研究的深入,以及对健康重视程度的增加,国内外精准医学均获得了飞速发展,相关技术不断成熟,精准医学体系逐步形成,其理念和研究范式不断深化,已开始在医学研究和临床应用中实践和推广。目前,已经有大量精准医学相关成果成功转化应用,其科学价值与战略价值进一步凸显。
尽管精准医学已取得重要进展,但目前仍然仅应用于少数疾病,相关药物开发和检测项目的覆盖面有明显不足,其临床应用依然面临诸多挑战。首先,由于疾病的复杂性,对疾病内在生物学特征的了解存在较大的局限性。其次,分子标志物存在较大的种族差异及地理区域差异,限制了不同种族及地区人群中相关精准医学研究成果的应用推广,加大了个体化精准医疗转化应用的难度。再次,个体化精准治疗需要医生同时掌握临床医学知识和精准医疗相关知识,而目前大部分医生还缺乏相关培训,还没有形成个体化精准医学的思维模式,且可操作个体化精准医疗检测的技术人员数量相对较少。此外,精准医学目前尚缺乏技术标准、法律规范,以及信息共享和信息保护机制。这些都是制约个体化精准医疗全面实施的重要因素。
虽然精准医学仍处于起步阶段,发展还面临诸多困难和障碍,但作为医学发展的前沿领域,精准医学体现了医学科学的发展趋势,也代表了临床实践发展的方向。精准医学的发展将对疾病临床诊疗的模式、路径、规范、指南、标准等产生革命性的影响,大幅提高疾病预防和诊疗水平,推动预防为主的健康管理体系的实现,同时将带来整个健康医疗领域产业链的快速革新,推动疾病诊疗产品与服务的全面升级,形成新的健康经济增长点,推动经济发展。未来,随着精准医学相关技术的进一步发展和完善,精准医学必将显现出巨大的发展和应用潜力。
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(秦胜营,赵祥龙,邢清和,许丽,孙学会,徐萍,苏燕,丁蕾,贺林)