肺结节多学科整合门诊及系统随访在肺癌早期诊疗中的作用

目的总结分析肺结节多学科整合门诊及系统随访在肺癌早期诊疗中的作用。 方法总结开展肺结节多学科整合门诊1年来就诊量、患者基本情况、门诊诊断和建议、随访情况、手术情况、病理情况等信息。分析多学科整合门诊通过提高早期肺癌诊断的准确率和随访率，实现肺癌早诊、早治方面的作用。 结果共看诊134例患者，261个肺结节，诊断为早期肺癌的患者占54.5%(73/134)，建议手术患者55例(占41.0%)，实际手术患者50例(37.3%)，术后确诊IA期以前的早期肺癌(包括非典型腺瘤样增生、原位癌、微浸润腺癌、浸润癌)占33.6%(45/134)，早期肺癌的门诊诊断准确率为90.0%(45/50)。有73.3%(33/45)的早期肺癌既往在外院诊断为良性肺结节，建议无须治疗或复查。 结论通过肺结节多学科整合门诊和系统随访的形式，能更好地发现早期肺癌，降低误诊率，实现早诊、早治，降低肺癌相关病死率。

Role of multidisciplinary integrated outpatient and systematic follow-up for pulmonary nodules in early diagnosis and treatment of lung cancer

ObjectiveTo explore the role of multidisciplinary integrated outpatient and systematic follow-up for pulmonary nodulesin the early diagnosis and treatment of lung cancer. MethodsThe information about number of outpatient visit, demographics, diagnosis and suggestions at outpatient, follow-up, surgery and pathologicalfindingsof multidisciplinary integrated outpatient for pulmonary nodules during a whole year was summarized, and the role of multidisciplinary integrated outpatient for pulmonary nodules in promoting the accuracy of diagnosis of early lung cancer and rate of follow-up was investigated. ResultsA total of 134 patients visited multidisciplinary integrated outpatient for pulmonary nodules, and there were 261 pulmonary nodules. Early lung cancer was diagnosed in 54.5%(73/134) of patients, surgery was suggested in 41.0%(55/134) of patients, and operation was finally performed in 50 patients(37.3%). Early lung cancer before IA stage (including atypical adenomatous hyperplasia, adenocarcinoma in situ, microinvasive adenocarcinoma, and invasive pulmonary adenocarcinoma) was confirmed after operation in 33.6% of patients(45/134), and the accuracy of diagnosis of early lung cancer by multidisciplinary integrated outpatient was 90.0%(45/90). Thirty-three out of 45 patients(73.3%) with early lung cancer were diagnosed as benign pulmonary nodules in other hospitals, and were advised not to receive treatment or reexamination. ConclusionsMultidisciplinary integrated outpatient and systematic follow-up for pulmonary nodules may play a role in the early diagnosis of lung cancer, and may help to reduce the related mortality of lung cancer.