磨玻璃结节型肺癌患者的个体化全程管理策略

随着胸部低剂量CT的普及,磨玻璃结节(ground-glass opacity,GGO)的检出率逐年升高.影像学表现为GGO的肺部病变病理上可能是良性病变,但持续存在的GGO多提示早期肺癌.GGO型肺癌和传统肺癌不同,常见于年轻、女性和不吸烟人群,具有惰性生长的特点,外科处理窗口期长,GGO是部分传统肺癌的早期表现.G...

Personalized treatment strategy for ground-glass opacity-featured lung cancer

Along with the popularity of low-dose computed tomography lung cancer screening,an increasing number of lung ground-glass opacity(GGO)lesions are detected.The pathology of GGO could be benign,but persistent GGO indicates early-stage lung cancer.Distinct from traditional lung cancer,GGO-featured lung cancer is more common in the young,nonsmokers and females.GGO-featured lung cancer represents an indolent type of malignancy with a long time to intervene.However,there is still no consensus on the screening,pathology,surgical procedure,and postoperative surveillance of GGO-featured lung cancer.Therefore,we proposed a personalized treatment strategy for GGO-featured lung cancer.The screening for GGO-featured lung cancer should be conducted at young age and low frequency.Adenocarcinoma in situ,minimally invasive adenocarcinoma,lepidic,and non-lepidic growth patterns could present as GGO.The following issues should be taken into consideration while determining the treatment of GGO-featured lung cancer:avoiding treating benign disease as malignancies,avoiding treating early-stage disease as advanced-stage disease,avoiding treating indolent malignancy as aggressive malignancy,and choosing appropriate timing to receive surgery without affecting life tracks and career developments.Bronchoscope and bone scan are not necessary for preoperative examinations of GGO-featured lung adenocarcinoma.For selected patients,sublobar resection without mediastinal lymph node dissection might be sufficient.Intraoperative frozen section is an effective method to guide resection strategy.Given the excellent survival of GGO-featured lung cancer,a less intensive postoperative surveillance strategy may be sufficient.