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偶然发现的肺结节的诊断方法。

Diagnostic approach for incidental pulmonary nodules.

作者信息

Park SeungYong, Park Seoung Ju

机构信息

Division of Respiratory, Allergy and Critical Care Medicine, Department of Internal Medicine, Research Institute of Clinical Medicine of Jeonbuk National University, Jeonbuk National University Medical School, Jeonju, Korea.

出版信息

Korean J Intern Med. 2025 Sep;40(5):710-724. doi: 10.3904/kjim.2025.107. Epub 2025 Aug 26.

Abstract

Lung cancer remains a leading cause of cancer-related mortality worldwide and is often diagnosed at an advanced stage, with poor survival outcomes. Early detection and appropriate management of incidental pulmonary nodules, frequently identified through low-dose computed tomography screening, are critical for improving prognosis and reducing lung cancer mortality. Established guidelines, including those of the Fleischner Society and American College of Radiology, provide structured recommendations for risk assessment, surveillance, and intervention. Recent advancements in diagnostic modalities, such as positron emission tomography, endobronchial ultrasound, electromagnetic navigation bronchoscopy, and robot-assisted bronchoscopy, have enhanced the diagnostic accuracy while minimizing procedural risks. A multidisciplinary approach that incorporates these technologies is essential for optimizing patient care. This review summarizes the current strategies for evaluating and managing solitary pulmonary nodules, including risk stratification models, imaging features, and biopsy techniques, thereby providing a comprehensive overview for clinicians.

摘要

肺癌仍然是全球癌症相关死亡的主要原因,且常常在晚期才被诊断出来,生存结果不佳。通过低剂量计算机断层扫描筛查经常发现的偶然肺结节的早期检测和适当管理,对于改善预后和降低肺癌死亡率至关重要。既定的指南,包括弗莱施纳学会和美国放射学会的指南,为风险评估、监测和干预提供了结构化建议。正电子发射断层扫描、支气管内超声、电磁导航支气管镜检查和机器人辅助支气管镜检查等诊断方式的最新进展提高了诊断准确性,同时将操作风险降至最低。采用这些技术的多学科方法对于优化患者护理至关重要。本综述总结了目前评估和管理孤立性肺结节的策略,包括风险分层模型、影像学特征和活检技术,从而为临床医生提供全面概述。

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