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《肺结节诊治中国专家共识(2024年版)》

[Chinese expert consensus on diagnosis and treatment of pulmonary nodules(2024)].

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2024 Aug 12;47(8):716-729. doi: 10.3760/cma.j.cn112147-20231109-00300.

Abstract

Lung cancer is the leading cause of the incidence and mortality of malignant tumors in China. The 5-year survival rate released for China in 2018 was 19.7%. The 5-year survival rate for stage Ⅰ patients is 77%-92%. Early diagnosis and treatment of lung cancer are key to improving the 5-year overall survival rate and prognosis of lung cancer patients. Therefore, experts from the Academic Group of Lung Cancer in Chinese Thoracic Society and Chinese Alliance Against Lung Cancer Expert Group formulated the in 2015 to standardize the diagnosis and treatment of lung nodules. In 2018, this consensus was updated to formulate the , and widely applied in multiple branch centers of Chinese Alliance Against Lung Cancer, proposing the . Based on applied experience of the expert consensus in recent years, with reference to the latest evidence has been updated, was formulated. The updated content of this consensus mainly includes the following aspects: (1) Define the screening age of high-risk lung cancer populations in China based on the national conditions; (2) Propose definition of "difficult-to-determine pulmonary nodules" to avoid delaying the diagnosis and treatment; (3) Evaluate pulmonary nodules assisted by artificial intelligence (AI) imaging-assisted diagnostic system and propose human-machine MDT to avoid the limitations of AI; (4) Evaluate pulmonary nodules by routine and individualized evaluations for different populations, and make recommendations based on evidence-based management guidelines for different types and sizes of pulmonary nodules. In the updated consensus, 18 consensus points were recommended as a reference for clinical management of pulmonary nodules to improve the 5-year overall survival rate and the prognosis of lung cancer in China.

摘要

肺癌是中国恶性肿瘤发病和死亡的主要原因。2018年发布的中国肺癌5年生存率为19.7%。Ⅰ期患者的5年生存率为77%-92%。肺癌的早期诊断和治疗是提高肺癌患者5年总生存率和预后的关键。因此,中国胸外科肺癌学术组和中国肺癌防治联盟专家组的专家于2015年制定了相关内容以规范肺结节的诊断和治疗。2018年,该共识进行了更新,制定了新的版本,并在中国肺癌防治联盟的多个分中心广泛应用,提出了相关建议。基于近年来专家共识的应用经验,参考最新更新的证据,制定了本共识。本共识的更新内容主要包括以下几个方面:(1)根据国情确定中国高危肺癌人群的筛查年龄;(2)提出“难定性肺结节”的定义,避免延误诊断和治疗;(3)采用人工智能(AI)影像辅助诊断系统辅助评估肺结节,并提出人机多学科诊疗模式以避免AI的局限性;(4)对不同人群进行常规和个体化评估以评估肺结节,并根据不同类型和大小肺结节的循证管理指南提出建议。在更新后的共识中,推荐了18个共识要点作为肺结节临床管理的参考,以提高中国肺癌的5年总生存率和预后。

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