摘要
肺结节是由诸多因素导致的局灶性肺部阴影,随着胸部低剂量螺旋CT的广泛应用,其检出率显著提高。准确鉴别检出结节的良恶性、及时对恶性肺结节实施干预可明显提高肺癌患者的生存率、改善预后。本综述主要对影像学及生物标志物在肺结节良恶性鉴别中的研究进展及应用进行总结。以“肺结节”“鉴别诊断”“影像学”“生物标志物”为关键词,检索2017-11-01-2022-11-01中国知网全文数据总库及PubMed检索平台的相关文献。纳入标准:影像检查发现肺结节,即直径≤30 mm肺实质内病灶;影像学及生物标志物在肺结节鉴别诊断中的研究与应用。排除标准:灵敏度、特异度等一般的应用研究;年份久远(近5年以外)且参考价值低的文献。最终纳入分析文献45篇。结果显示,目前鉴别肺结节的金标准仍是活体组织病理检查(简称活检),但受限于其有创、高风险等缺点未能常规应用。通过探索影像学及生物标志物的潜在价值,肺结节的鉴别效能得以不断提高,如融合多项肺结节的影像特征等构建预测模型、新型技术方式的加持、探寻高效能的生物标志物、液体活检技术的应用等。提示,影像学及生物标志物检测方式凭借可重复性好、安全性高等优势,有望广泛应用于临床以诊断肺结节,两者的联合应用效能更高。但目前各项检测技术的敏感性与特异性未达到理想化水平,临床常规应用的可行性、方便性仍待研究验证。
Pulmonary nodule is a focal pulmonary shadow caused by many factors.With the extensive application of chest low-dose spiral computed tomography(CT),its detection rate has been significantly improved.Accurate identification of benign and malignant nodules and timely intervention of malignant pulmonary nodules can significantly improve the survival rate and prognosis of patients with lung cancer.This review mainly summarizes the research progress and application of imaging and biomarkers in the differentiation of benign and malignant pulmonary nodules.With"pulmonary nodules","differential diagnosis","imaging"and"biomarkers"as the key words,relevant literatures were retrieved from CNKI full-text database and PubMed retrieval platform from November 1,2017 to November 1,2022.Inclusion criteria:imaging examination found pulmonary nodules,namely lesions within the lung parenchyma with a diameter≤30 mm;Study and application of imaging and biomarkers in the differential diagnosis of pulmonary nodules.Exclusion criteria:The application research of low sensitivity and specificity;Outdated(nearly 5 years ago)literature with low reference value.Finally,45 literature were included in the analysis.The results showed that the current gold standard for the identification of pulmonary nodules was still biopsy,but it could not be routinely applied due to its disadvantages such as invasions and high risk.By exploring the potential value of imaging and biomarkers,the identification efficiency of pulmonary nodules has been continuously improved,such as the construction of prediction models by integrating the image features of multiple pulmonary nodules,the addition of new technical means,the exploration of high-efficiency biomarkers,the application of liquid biopsy technology,etc.Imaging and biomarker detection methods are expected to be widely used in clinical diagnosis of pulmonary nodules due to their advantages of good repeatability and high safety,and the combined application of the two methods is more effective.However,the sen
作者
景凤婷
刘文健
JING Fengting;LIU Wenjian(Graduate School,Shandong First Medical University and Shandong First Medical Sciences,Jinan 250100,China;Department of Oncology,Second Af filiated Hospital of Shandong First Medical University,Taian 271000,China)
出处
《社区医学杂志》
CAS
2023年第5期270-274,共5页
Journal Of Community Medicine
关键词
肺结节
鉴别诊断
影像学
生物标志物
综述文献
pulmonary nodule
differential diagnosis
imaging
biomarker
review literature
