NCCN 肿瘤临床实践指南-非小细胞肺癌 NCCN指南 2020V3（讨论）双语对照正式版.ppt

Discussion;Staging;General Principles;Additional Pretreatment Evaluation 治疗前的其他评估;Summary;Subsequently, the NCCN Guidelines have been updated at least once a year by the NCCN NSCLC Panel; there were 7 updates for the 2019 guidelines. 随后，NCCN NSCLC专家组至少每年更新一次《NCCN指南?》；2019年指南有 7次更新。 The Summary of the Guidelines Updates describes the most recent revisions to the algorithms, which have been incorporated into this updated Discussion text (see the NCCN Guidelines for NSCLC and Summary in this Discussion). 指南更新概要描述了最新修订的工作步骤，已纳入此更新的讨论正文中（请参阅《NCCN NSCLC指南》和本讨论中的“小结”）。;;;;Programs using behavioral counseling combined with medications that promote smoking cessation (approved by the FDA) can be very useful. 使用行为咨询和（经 FDA 批准的）促进戒烟药物的计划是非常有用的。 The American Cancer Society (ACS) has a Guide to Quitting Smoking. 美国癌症协会（ACS）有一个《戒烟指南》。;;NSCLC占所有肺癌病例的 80％以上，包括 2种主要类型：1）非鳞（包括腺癌、大细胞 癌和其他亚型）；和 2）鳞状细胞（表皮样）癌。;the NLST.;;决定是否适合活检（包括活检类型）或手术切除取决于若干因素，在 NSCLC工作步骤中 概述（请参阅《NSCLC NCCN指南》中的“诊断评估原则”）。;Diagnosis, staging, and planned resection (eg, lobectomy) are ideally one operative procedure for patients with early-stage disease (see the Principles of Diagnostic Evaluation in the NCCN Guidelines for NSCLC).;The mediastinal lymph nodes are systematically sampled to determine the staging and therapeutic options.;Further details are provided in the algorithm.;;国际专家组和 NCCN NSCLC专家组推荐对所有腺癌患者进行 EGFR突变检测；NCCN NSCLC 专家组还推荐患者接受常规生物标记物检测，以检测间变性淋巴瘤激酶（ALK）基因重 排（也称为 ALK融合）、ROS1重排（也称为 ROS1融合）、BRAF突变和程序性死亡配体 1 （PD- L1）表达水平，因为这些生物标记物可使用 FDA批准的肺癌治疗药。 Testing for other genetic variants may also be done—such as neurotrophin tyrosine receptor kinase (NTRK) gene fusions, RET fusions, MET genetic variants, and ERBB2 (also known as HER2) mutations—to identify these rare oncogenic driver variants for which effective therapy may be available, although there is less evidence to support testing (see Emerging Biomarkers to Identify Novel Therapies for Patients with Metastatic NSCLC in the NCCN Guidelines for NSCLC).;如有必要