肺磨玻璃结节的影像学、病理学特点及临床管理

The radiology,pathology and clinical management of grand-glass opacity lung nodules

随着CT应用于肺癌的筛查,检出了越来越多的肺癌玻璃结节(GGO),不过这其中良恶性混杂,让人难以辨识。而本文总结了现今最新的GGO影像学及病理学特点,发现这两者之间并非绝无联系。同时我们还回顾了多个学会的最新指南,讨论了GGO的管理及随访。此外有创的活检和GGO标记后手术切除是亟待发展的领域。早期肺癌的标准治疗仍是微创的肺叶切除及淋巴结清扫术,不过近来有研究表明亚肺叶切除也有一定的可行性,这或许会引领未来肺癌的治疗方向。

The advent of computed tomography screening for lung cancer will increase the incidence of ground - glass opacity （GGO） nodules detected and referred for diagnostic evaluation and management. GGO nodules remain a diagnostic challenge,and we present the latest advances in the radiologic imaging and pathology of GGO nodules,dem-onstrating that radiologic features are increasingly predictive of the pathology of GGO nodules. We review the current guidelines from sevsral academies,and we discuss the management and follow - up of GGO nodules. Minimally inva-sive tissue biopsies and the marking of GGO nodules for surgery are new and rapidly developing fields. The standard - of - care surgical treatment of early lung cancer is still minimally invasive lobectomy with systematic lymph node dis-section. However,recent research has shown that some GGO lesions may be treated with sublobar resections; these findings may expand the surgical treatment options available in the future.