肺结节诊治中国专家共识(2024年版)

Chinese expert consensus on diagnosis and treatment of pulmonary nodules(2024)

肺癌发病率与病死率在我国居恶性肿瘤之首,目前我国肺癌5年生存率为19.7%,肺癌Ⅰ期患者5年生存率可达77%~92%,肺癌早期诊断和治疗是提高肺癌5年生存率、改善患者预后的关键。为此中华医学会呼吸病学分会肺癌学组、中国肺癌防治联盟组织专家于2015年制定了《肺部结节诊治中国专家共识》,2018年对该共识进行了更新,形成了《肺结节诊治中国专家共识(2018年版)》,并在中国肺癌防治联盟肺结节诊治分中心推广,提出“智能救治百万早期肺癌工程”,规范和提高了我国肺结节暨早期肺癌诊治水平。在此背景下,根据近年来中国肺癌防治联盟肺结节诊治分中心的推广经验,更新现有的文献证据,对该共识进行第三次修订和更新,形成了《肺结节诊治中国专家共识(2024年版)》。本次共识更新内容主要包括以下几个方面:(1)根据我国国情界定我国肺癌高危人群筛查年龄;(2)提出难定性肺结节定义以避免延误诊断和治疗;(3)对人工智能(artificial intelligence,AI)影像辅助诊断系统评估肺结节以科学评价,并提出人机MDT以避免AI的局限性;(4)将肺结节评估分为常规和个体化评估,基于循证医学证据对于不同类型和大小肺结节管理细则给予了推荐。本共识共形成18条推荐意见指导肺结节暨肺癌早期诊治临床实践,以规范和提高我国肺结节暨早期肺癌的诊治水平,提高肺癌5年生存率、改善患者预后。

Lung cancer is the leading cause of the incidence and mortality of malignant tumors in China.The 5-year survival rate released for China in 2018 was 19.7%.The 5-year survival rate for stageⅠpatients is 77%-92%.Early diagnosis and treatment of lung cancer are key to improving the 5-year overall survival rate and prognosis of lung cancer patients.Therefore,experts from the Academic Group of Lung Cancer in Chinese Thoracic Society and Chinese Alliance Against Lung Cancer Expert Group formulated the Chinese Expert Consensus on the Diagnosis and Treatment of Lung Nodules in 2015 to standardize the diagnosis and treatment of lung nodules.In 2018,this consensus was updated to formulate the Chinese Expert Consensus on Diagnosis and Treatment of Lung Nodules(2018 edition),and widely applied in multiple branch centers of Chinese Alliance Against Lung Cancer,proposing the Intelligent Treatment of Million Early Lung Cancer Project.Based on applied experience of the expert consensus in recent years,with reference to the latest evidence has been updated,Chinese Expert Consensus on Diagnosis and Treatment of Lung Nodules(2024 edition)was formulated.The updated content of this consensus mainly includes the following aspects:(1)Define the screening age of high-risk lung cancer populations in China based on the national conditions;(2)Propose definition of“difficult-to-determine pulmonary nodules”to avoid delaying the diagnosis and treatment;(3)Evaluate pulmonary nodules assisted by artificial intelligence(AI)imaging-assisted diagnostic system and propose human-machine MDT to avoid the limitations of AI;(4)Evaluate pulmonary nodules by routine and individualized evaluations for different populations,and make recommendations based on evidence-based management guidelines for different types and sizes of pulmonary nodules.In the updated consensus,18 consensus points were recommended as a reference for clinical management of pulmonary nodules to improve the 5-year overall survival rate and the prognosis of lung cancer in China.