Lung nodules: size still matters.
Lung nodules: size still matters.
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DOI：
10.1183/16000617.0025-2017
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发表时间：
2017-12-31
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--
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中科院分区：
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近年来，不明原因肺结节的发病率不断上升。肺结节恶性的确定是至关重要的，因为肺癌的早期诊断可能导致明确的干预。根据目前的国际指南，大小和生长速度是确定肺结节性质的主要指标。然而，当只考虑结节的尺寸时，在评价和描述结节的特征方面存在一些局限性。没有单一的结核测量方法，在手工或自动或半自动方法进行测量时，确实存在内在误差，这些误差可能决定结核测量和生长评估的差异。当考虑到亚实性结节时，实性成分的存在和大小是恶性和结节处理的主要决定因素，如最新指南所报道的。然而，其他结节形态学特征与恶性肿瘤风险增加相关。此外，在确定恶性肿瘤的可能性时，不应忽视临床背景。预测模型已被提出作为一种潜在的手段，以克服基于大小的评估不确定的肺结节的恶性风险的局限性。规模和增长率仍然是结核管理的主要决定因素http://ow.ly/mtDB30gugUg
The incidence of indeterminate pulmonary nodules has risen constantly over the past few years. Determination of lung nodule malignancy is pivotal, because the early diagnosis of lung cancer could lead to a definitive intervention. According to the current international guidelines, size and growth rate represent the main indicators to determine the nature of a pulmonary nodule. However, there are some limitations in evaluating and characterising nodules when only their dimensions are taken into account. There is no single method for measuring nodules, and intrinsic errors, which can determine variations in nodule measurement and in growth assessment, do exist when performing measurements either manually or with automated or semi-automated methods. When considering subsolid nodules the presence and size of a solid component is the major determinant of malignancy and nodule management, as reported in the latest guidelines. Nevertheless, other nodule morphological characteristics have been associated with an increased risk of malignancy. In addition, the clinical context should not be overlooked in determining the probability of malignancy. Predictive models have been proposed as a potential means to overcome the limitations of a sized-based assessment of the malignancy risk for indeterminate pulmonary nodules. Size and growth rate remain the main determinants of nodule management http://ow.ly/mtDB30gugUg
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