Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200090, China ;
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany ;
Transl Lung Cancer Res. 2016 Aug;5(4):377-88. doi: 10.21037/tlcr.2016.07.09.
The first Chinese-German Lung Cancer Expert Panel was held in November 2015 one day after the 7th Chinese-German Lung Cancer Forum, Shanghai. The intention of the meeting was to discuss strategies for the diagnosis and treatment of lung cancer within the context of lung cancer screening. Improved risk classification criteria and novel imaging approaches for screening populations are highly required as more than half of lung cancer cases are false positive during the initial screening round if the National Lung Screening Trial (NLST) demographic criteria [≥30 pack years (PY) of cigarettes, age ≥55 years] are applied. Moreover, if the NLST criteria are applied to the Chinese population a high number of lung cancer patients are not diagnosed due to non-smoking related risk factors in China. The primary goal in the evaluation of pulmonary nodules (PN) is to determine whether they are malignant or benign. Volumetric based screening concepts such as investigated in the Dutch-Belgian randomized lung cancer screening trial (NELSON) seem to achieve higher specificity. Chest CT is the best imaging technique to identify the origin and location of the nodule since 20% of suspected PN found on chest X-ray turn out to be non-pulmonary lesions. Moreover, novel state-of-the-art CT systems can reduce the radiation dose for lung cancer screening acquisitions down to a level of 0.1 mSv with improved image quality to novel reconstruction techniques and thus reduce concerns related to chest CT as the primary screening technology. The aim of the first part of this manuscript was to summarize the current status of novel diagnostic techniques used for lung cancer screening and minimally invasive treatment techniques for progressive PNs that were discussed during the first Chinese-German Lung Cancer. This part should serve as an educational part for the readership of the techniques that were discussed during the Expert Panel. The second part summarizes the consensus recommendations that were interdisciplinary discussed by the Expert Panel.
2015 年 11 月，在第七届中德肺癌论坛结束的第二天，第一届中德肺癌专家小组会议在上海举行。会议的目的是讨论在肺癌筛查背景下的肺癌诊断和治疗策略。如果应用美国国家肺癌筛查试验（NLST）的人群标准（≥30 包年的吸烟史，年龄≥55 岁），那么在最初的筛查轮次中，超过一半的肺癌病例为假阳性，因此需要改进风险分类标准和新的筛查人群成像方法。此外，如果将 NLST 标准应用于中国人群，由于中国与吸烟无关的危险因素，大量肺癌患者未被诊断出来。在评估肺结节（PN）时，主要目标是确定其是恶性还是良性。荷兰-比利时随机肺癌筛查试验（NELSON）中研究的基于体积的筛查概念似乎具有更高的特异性。胸部 CT 是识别结节起源和位置的最佳成像技术，因为在胸部 X 射线上发现的 20%疑似 PN 实际上是非肺部病变。此外，新型先进 CT 系统可以将肺癌筛查采集的辐射剂量降低到 0.1 mSv 以下，同时通过新的重建技术提高图像质量，从而降低对作为主要筛查技术的胸部 CT 的担忧。本文第一部分的目的是总结用于肺癌筛查的新型诊断技术和进展性 PN 的微创治疗技术的最新进展，这些技术是在第一届中德肺癌会议期间讨论的。这一部分应为读者提供有关在专家小组讨论期间讨论的技术的教育部分。第二部分总结了专家小组跨学科讨论的共识建议。
