Jiang Gening, Xie Dong
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China; Email:
Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.
Zhonghua Wai Ke Za Zhi. 2015 Oct 1;53(10):790-3.
The incidence of ground-glass opacity (GGO)-dominant lung cancer is rising in China. The review is focused on the diagnosis and therapy for GGO-dominant lung cancer. CT screening in high-risk groups is recommended for early diagnosis of GGO-dominant lung cancer. The early diagnosis of GGO-dominant lung cancer depends on dynamic observation on the chest CT. Non-surgical biopsy or PET/CT has limited diagnostic value in GGO-dominant lung cancer. Video-assisted Thoracoscopic resection (VATS) is the mainstream treatment for GGO-dominant lung cancer. Single-port VATS, VATS segmentectomy, robot-assisted VATS, and subxiphoid VATS are the new directions of minimally invasive surgery. GGO intraoperative localization can be integrated using a variety of models. Sublobectomy could be used in the therapy for adenocarcinoma in situ, minimally invasive adenocarcinoma or pure GGO with 2.0 cm or less in diameter. Surgery for multiple GGO need an individualized strategy.
在中国,以磨玻璃影(GGO)为主的肺癌发病率正在上升。本综述聚焦于以GGO为主的肺癌的诊断与治疗。建议对高危人群进行CT筛查以早期诊断以GGO为主的肺癌。以GGO为主的肺癌的早期诊断依赖于胸部CT的动态观察。非手术活检或PET/CT在以GGO为主的肺癌中诊断价值有限。电视辅助胸腔镜手术(VATS)是治疗以GGO为主的肺癌的主流方法。单孔VATS、VATS肺段切除术、机器人辅助VATS及剑突下VATS是微创手术的新方向。GGO术中定位可采用多种模式综合应用。肺段以下切除术可用于原位腺癌、微浸润腺癌或直径2.0 cm及以下的纯GGO的治疗。对于多发GGO的手术需要个体化策略。