摘要在我国,表现为局灶性磨玻璃样影(GGO)的早期肺癌发病率迅速升高.在高危人群中开展低剂量螺旋CT筛查,有利于疾病的早期诊断.GGO早期肺癌的诊断主要依赖于动态观察胸部CT,PET-CT、术前非手术活检对于纯GGO诊断价值有限,假阴性率高.胸腔镜手术(VATS)是GGO早期肺癌的主流治疗术式,单孔VATS、VATS肺段切除术、机器人辅助VATS及剑突下单孔VATS等是微创手术发展的新方向.GGO的术中定位可综合采用多种模式;预计病灶为原位腺癌、微浸润腺癌或最大径<2 cm的纯GGO可考虑亚肺叶切除;同期多发GGO需要个体化设计手术方案.
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abstractsThe 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,robotassisted 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.
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