Risk assessment and interventions for malignant ground-glass lung nodules

Pulmonary ground-glass nodules (GGNs) have become a major problem owing to their high frequency, limited diagnostic differentiation, complex pathogenesis, and lack of effective intervention strategies. With the ongoing increase in the frequency of pulmonary nodules and improved control of smoking, GGNs may become the predominant manifestation of early-stage lung cancer (LC) in the future. However, current diagnostic approaches are limited in terms of both accuracy and specificity, leading to a dual challenge of overtreatment and delayed intervention. The present review briefly summarizes the most recent research on the scientific and clinical dimensions of early diagnosis and treatment for malignant GGNs. We summarize key population characteristics, imaging features, imaging pathological analysis, and biomarkers, encompassing genetic alterations, RNA, circulating tumor DNA, DNA methylation, autoantibodies, proteins, metabolites, the microbiome, circulating tumor cells, blood parameters, angiogenic markers, volatile biomarkers, and reactive oxygen species indicators. Additionally, we assess predictive models, recent and potential therapeutic strategies, artificial intelligence studies, and discuss intrinsic biological mechanisms, while highlighting key challenges in LC diagnosis and treatment. This review highlights that novel technologies and multidisciplinary approaches hold considerable potential in advancing precise early diagnosis, which is critical for reducing LC incidence.