最新 非实性结节的诊断和处理指南.pptVIP

2021/4/26 There are no predictive CT features to aid in differentiating lesions likely to progress versus those that remain stable. stable Histologic analysis of the second lesion showed mixed subtype adenocarcinoma composed of acinar adenocarcinoma (40%) and BAC(AIS) (60%). 2、多发性非实性肺结节 Patients with Multiple Subsolid Nodules 由于多发非实性结节的组织亚型分布与多发实性结节不同，所以治疗的效果尚不清楚； 同为多发性非实性结节，多发5mm以下的GGO结节与多发大小不等的非实性结节的治疗不同； 多发结节中10mm以上或有实性成分的结节的局部切除价值有待确定。 Variable-sized subsolid nodules. (a) Magnified 1-mm CT section through the right upper lobe shows multiple small lesions with GGO and one dominant larger nodule with GGO (arrow). (b) CT scan at 4-year follow-up shows no substanital interval change (arrow) and the lesions were presumed to represent AAH and BAC(AIS) (dominant lesion). Multiple subsolid nodules with variable size and appearance. (a, b) Sequential axial 1-mm CT sections through the mid thorax in the same patient show multiple subsolid pulmonary nodules differing in size and attenuation located in the superior segment of the right and left lower lobes (arrows), including nodules with mixed solid component and GGO, nodules with GGO, and a solid nodule. In such cases, selective limited resection of the dominant lesions may be acceptable. 3、肺内非实性结节过度诊断了吗？Is There Overdiagnosis of Lung Cancer in Patients with Subsolid Nodules? CT发现的非实性结节基本都过度诊断和过度治疗了。 Carter et al：37个年度筛查发现的174个肺癌中，84例为非实性结节，其中只有14（17%）例手术切除后证实有侵袭性。 非实性结节的侵袭性高低今后有望通过生物标记物等的检测而预判。 2001.12.26 2002.12.11 2005.07.12 2006.10.26 Suggested Guidelines in theManagement of Subsolid Nodules Lesions Smaller than 10 mm with Pure GGO Solitary Lesions 10 mm or Larger in Size with GGO Lesions with Mixed Solid Component and GGO Multiple Subsolid Nodules 8 肺内非实性结节诊断处理指南Subsolid Pulmonary Nodules and the Spectrum of Peripheral Adenocarcinomas of the Lung: Recommended Interim Guidelines for Assessment and Management screen 2.9-19% 由Nordri?（ ） 设计提供 LOGO GGN的病理基础 GGN的CT-病理对照研究及预后的相关性 良恶性GGN的鉴别诊断 GGN的处理指南 G