周围型小肺癌的诊断和治疗

Diagnosis and treatment of small peripheral lung cancer

周围型小肺癌的构成比约占同期肺癌的10％左右。经手术切除5年生存率超过80％。Noguchi组织学分型的A型和B型在胸部CT上常常表现为磨玻璃影（GGO），5年生存率可达97．3％。即使是≤2cm的病灶，仍可伴有10％-30％的淋巴结转移。标准的治疗方法应为肺叶切除加系统纵隔淋巴结清除。除非病灶≤1cm且在胸部薄层高分辨CT上显示明显的GGO，则可考虑行病灶局部切除。

Small peripheral lung cancer which is less than 2cm in diameter comprises nearly 10% of the total lung cancer at the same phase. Over 80% 5-year survival rate is reported in surgically treated patients. CT increases the detection of the small peripheral lung cancers. Noguchi＇ s tumor growth patterns of small peripheral adenocarcinoma appear to correlate with the pattern of ground-glass opacity on high resolution CT with a 5-year survival rate of 97. 3%. But lymph adenopathy is still detected in 10% -30% tumors less than 2cm in diameter. So lobectomy with mediastinal lymph nodes dissection is a standard operative procedure for small peripheral lung cancer. Tumors within 1 cm and with the pattern of GGO on high resolution CT might be good candidates for limited operation. At least, mediastinal lymph nodes dissection is dispensable in such cases.