北京大学学报(医学版) ›› 2021, Vol. 53 ›› Issue (3): 628-631. doi: 10.19723/j.issn.1671-167X.2021.03.032

• 短篇论著 • 上一篇    

肺结节多学科联合诊治价值

欧阳雨晴,倪莲芳,刘新民()   

  1. 北京大学第一医院老年内科,北京 100034
  • 收稿日期:2019-05-14 出版日期:2021-06-18 发布日期:2021-06-16
  • 通讯作者: 刘新民 E-mail:lxm2128@163.com

  • Received:2019-05-14 Online:2021-06-18 Published:2021-06-16

RICH HTML

  

摘要:

关键词: 肺结节, 多学科联合门诊, 依从性

中图分类号: 

  • R734.2

表1

452例患者临床病理特征"

Variables n (%)
Gender
Male 199 (44.0)
Female 253 (56.0)
Age/years
<65 289 (63.9)
≥65 163 (36.1)
Nodule number
Solitary 169 (37.4)
Multiple 283 (62.6)
Nodule type
GGO 100 (22.1)
pSN 42 (9.3)
SN 248 (54.9)
N/A 62 (13.7)
Nodule location
Right upper lobe 71 (15.7)
Right middle lobe 32 (7.1)
Right lower lobe 54 (11.9)
Left upper lobe 49 (10.8)
Left lower lobe 35 (7.7)
Multi-lobe 211 (46.7)
Nodule size/mm, $\bar{x} \pm s$ 7.54±4.65
Histopathological type
Benign lesions 10 (21.7)
Preinvasive lesions 4 (8.7)
AAH 3 (6.5)
AIS 1 (2.2)
MIA 2 (4.3)
IA 24 (52.2)
Other 6 (13.0)

表2

肺结节多学科联合门诊建议的实施情况"

Management option Recommendation Unimplemented ratio, n(%)
Radiologic study 398 36 (9.0)
CT guided biopsy 22 14 (63.6)
Treatment
Surgery 52 21 (40.4)
Radiotherapy 4 4 (100)

表3

肺结节多学科联合门诊临床与病理诊断"

Pathologic diagnosis MDT diagnosis Total
Benign nodule Malignant nodule
Benign nodule 2 3 5
Malignant nodule 2 32 34
Total 4 35 39

图1

误诊病例1:胸部CT提示右肺中叶外侧段胸膜下可见部分实性结节"

图2

误诊病例2:胸部CT提示右肺上叶后段胸膜下可见部分实性结节"

图3

误诊病例3:胸部CT提示左肺上叶尖后段可见部分实性结节"

[1] Freeman RK, Van Woerkom JM, Vyverberg A, et al. The effect of a multidisciplinary thoracic malignancy conference on the treatment of patients with lung cancer[J]. Eur J Cardiothorac Surg, 2010,38(1):1-5.
doi: 10.1016/j.ejcts.2010.01.051
[2] Denton E, Conron M. Improving outcomes in lung cancer: the value of the multidisciplinary health care team[J]. J Multidiscip Healthc, 2016,9:137-144.
doi: 10.2147/JMDH.S76762 pmid: 27099511
[3] MacMahon H, Naidich DP, Goo JM, et al. Guidelines for management of incidental pulmonary nodules detected on ct images: from the fleischner society 2017[J]. Radiology, 2017,284(1):228-243.
doi: 10.1148/radiol.2017161659 pmid: 28240562
[4] Huang P, Park S, Yan R, et al. Added value of computer-aided CT image features for early lung cancer diagnosis with small pulmonary nodules: a matched case-control study[J]. Radiology, 2018,286(1):286-295.
doi: 10.1148/radiol.2017162725 pmid: 28872442
[5] Hou S, Lin X, Wang S, et al. Combination of positron emission tomography/computed tomography and chest thin-layer high-resolution computed tomography for evaluation of pulmonary nodules: correlation with imaging features, maximum standardized uptake value, and pathology[J]. Medicine (Baltimore), 2018,97(31):e11640.
doi: 10.1097/MD.0000000000011640
[6] Gao F, Ge X, Li M, et al. CT features of lung scar cancer[J]. J Thorac Dis, 2015,7(3):273-280.
[7] Baldwin DR, Callister ME. The British Thoracic Society guidelines on the investigation and management of pulmonary nodules[J]. Thorax, 2015,70(8):794-798.
doi: 10.1136/thoraxjnl-2015-207221 pmid: 26135833
[8] Yang W, Sun Y, Fang W, et al. High-resolution computed tomography features distinguishing benign and malignant lesions manifesting as persistent solitary subsolid nodules[J]. Clin Lung Cancer, 2018,19(1):e75-e83.
doi: 10.1016/j.cllc.2017.05.023
[9] Lee HY, Choi YL, Lee KS, et al. Pure ground-glass opacity neoplastic lung nodules: histopathology, imaging, and management[J]. AJR Am J Roentgenol, 2014,202(3):W224-233.
doi: 10.2214/AJR.13.11819
[10] van Riel SJ, Sánchez CI, Bankier AA, et al. Observer variability for classification of pulmonary nodules on low-dose CT images and its effect on nodule management[J]. Radiology, 2015,277(3):863-871.
doi: 10.1148/radiol.2015142700
[1] 张晗,秦亦瑄,韦帝远,韩劼. 牙周炎患者种植修复维护治疗依从性的影响因素[J]. 北京大学学报(医学版), 2024, 56(1): 39-44.
[2] 陈平,黎泽明,郭怡,孙昕霙,Edwin B.FISHER. 基于大五人格理论应用潜在剖面分析探究2型糖尿病患者的用药依从性[J]. 北京大学学报(医学版), 2021, 53(3): 530-535.
[3] 金蕾,王程,张杰,孟文颖,张佳煜,于锦慧,蔺桂银,佟明坤,靳蕾. 妇女围受孕期叶酸服用情况及其对胎儿神经管缺陷的预防效果[J]. 北京大学学报(医学版), 2020, 52(4): 719-725.
[4] 欧阳雨晴,倪莲芳,刘新民. 恶性孤立性肺结节患者预后因素分析[J]. 北京大学学报(医学版), 2020, 52(1): 158-162.
[5] 倪莲芳, 刘新民. 血清肿瘤标记物对孤立性肺结节良恶性的诊断价值[J]. 北京大学学报(医学版), 2014, 46(5): 707-710.
[6] 李运, 陈克终, 隋锡朝, 卜梁, 周足力, 杨帆, 刘彦国, 赵辉, 李剑锋, 刘军, 姜冠潮, 王俊. 孤立性肺结节良恶性判断数学预测模型的建立[J]. 北京大学学报(医学版), 2011, 43(3): 450-454.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!