偶然的肺结节:差异诊断和临床管理
Philip Baum1, Kai Schlamp, Laura V Klotz
1Department of Thoracic Surgery, Thoraxklinik at Heidelberg University Medical Center, Heidelberg, Germany; Depatrment of Diagnostic and Interventional Radiology, Thoraxklinik at Heidelberg University Medical Center, Heidelberg, Germany; Thoraxklinik-Heidelberg gGmbH, Department of Pneumology and Respiratory Medicine, Heidelberg University Medical Center.
管理偶然发现的肺结节的指导方针改善了结果. 大多数结节都是良性的,但大小和风险因素影响恶性瘤的风险,指导后续或进一步评估.
科学领域:
- 肺部病理学 肺部病理学
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
背景情况:
- 偶然的肺结节很常见,男性和女性的特定发病率.
- 现有指导方针用于管理这些结节,旨在改善患者的治疗结果.
- 通过CT扫描检测到的结节的很大一部分是良性的,但管理往往偏离了指南.
研究的目的:
- 总结了偶然发现的肺结节的适当临床方法.
- 为肺结节提供诊断研究和其时间的概述.
- 确保管理与既定指导方针保持一致,防止过度或过少处理.
主要方法:
- 对相关的英语出版物进行了选择性的PubMed搜索.
- 审查了自2010年以来发布的关于肺结节管理的建议.
- 纳入了来自德国肺癌指南的评论.
主要成果:
- 偶发性肺结节中恶性瘤的风险通常很低,但随着结节的大小和患者的风险因素而增加.
- 管理策略包括随访胸部CT扫描或基于结节特征的高级评估 (PET-CT,活检).
- 在低风险患者中,小于6毫米的结节不需要随访;大约10%的8毫米以上的结节是恶性的.
结论:
- 对偶发性肺结节的准则的遵守旨在平衡过度治疗和治疗不足.
- 怀疑的结节需要由跨学科团队进行管理,以获得最佳护理.
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