肺部磨玻璃结节的诊治策略

Management Strategies of Pulmonary Ground Galss Nodule

肺部磨玻璃结节(ground glass nodule,GGN)是一种影像学表现,可能是肺部恶性肿瘤或良性病变。目前对于肺部磨玻璃结节的诊疗仍存在争议。2017年Fleischner协会和美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)都更新了GGN诊疗的指南,与之前的版本相比,手术或活检的指征更严,随访的间隔时间更长。临床工作中,GGN的大小、实性成分大小、动态随访变化和CT值都是判断手术介入时机的因素。GGN的诊疗中还存在一些误区:抗生素的使用、正电子发射型计算机断层显像(positron emission tomographycomputed tomography,PET-CT)检查、贴近胸膜的纯GGN和进入GGN的血管都是值得注意的问题。总之,GGN是一种发展缓慢的病灶,可以安全地进行随访。

Pulmonary ground glass nodule （GGN） is a term of radiological manifestation, which may be malignant or benign. The management for pulmonary GGN remains controversial. Both Fleischner society and National Comprehensive Cancer Network （NCCN） panel updated the guideline for the management of GGN in 2017. Compared with previous versions, the indication for surgery or biopsy is stricter, and the recommended follow-up interval is prolonged. In clinical practice, the size of GGN component, the size of consolidation component, dynamic change during follow-up and computed tomography （CT） value are the four factors that help surgeons to decide the timing of surgery. There are some misunderstandings for the management of GGN, such as the administration of antibiotics, the use of positron emission tomography-computed tomography （PET-CT）, pure GGN adjacent to visceral pleura, and GGN with penetrating vessel. In conclusion, GGN is a kind of slowly growing lesion, which can be followed up safely.