Chinese thoracic surgery expert consensus on rational diagnosis and treatment of pulmonary nodules with a diameter≤2 cm (2024)_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 HU Jian ¹ ,  ZHI Xiuyi ² ,  LIU Lunxu ³ , Chinese Medical Education Association Lung Cancer Medical Education Committee , Wu Jieping Medical Foundation Lung Cancer Professional Committee , Thoracic Surgery Branch of China Association for International Exchange of Medical Care , Chinese Anti-Cancer Association Lung Cancer Integrated Rehabilitation Professional Committee , Thoracic Surgeons Branch of Zhejiang Medical Doctors Association , Zhejiang Preventive Medicine Association Lung Cancer Prevention and Control Special Committee

1. Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, P. R. China;
2. Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, P. R. China;
3. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

HU Jian, Email: dr_hujian@zju.edu.cn; ZHI Xiuyi, Email: xiuyizhi2015@163.com; LIU Lunxu, Email: lunxu_liu@aliyun.com

Keywords：

Pulmonary nodules (≤2 cm); thoracic surgery; expert consensus

DOI：

10.7507/1007-4848.202406056

Video：

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With the increasing application of low-dose computed tomography and the rising public health awareness, the early detection of pulmonary nodules has become more prevalent. Pulmonary nodules, especially those with a diameter≤2 cm, pose a critical challenge in clinical practice due to the potential risk of progressing into malignant lung lesions. Guided by the principles of "avoiding both over-treatment and mistreatment", the goal is to standardize the clinical management of pulmonary nodules. The "Chinese thoracic surgery expert consensus on rational diagnosis and treatment of pulmonary nodules with a diameter≤2 cm (2024)" was developed after extensive consultation with nearly one hundred thoracic surgery experts in China, relying on large-scale clinical study data and referencing national and international guidelines and consensus. The consensus includes 29 recommendations, focusing on specific attributes such as the size, composition, and anatomical positioning of the nodules. It proposes targeted guidelines for screening, follow-up, diagnostic criteria, and recommendations for personalized treatment, surgical approaches, and protocols for rapid postoperative recovery.

Citation： HU Jian, ZHI Xiuyi, LIU Lunxu, Chinese Medical Education Association Lung Cancer Medical Education Committee, Wu Jieping Medical Foundation Lung Cancer Professional Committee, Thoracic Surgery Branch of China Association for International Exchange of Medical Care, Chinese Anti-Cancer Association Lung Cancer Integrated Rehabilitation Professional Committee, Thoracic Surgeons Branch of Zhejiang Medical Doctors Association, Zhejiang Preventive Medicine Association Lung Cancer Prevention and Control Special Committee. Chinese thoracic surgery expert consensus on rational diagnosis and treatment of pulmonary nodules with a diameter≤2 cm (2024). Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(8): 1077-1089. doi: 10.7507/1007-4848.202406056 Copy

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1. Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin, 2024, 74(1): 12-49.
2. Zheng RS, Chen R, Han BF, et al. Cancer incidence and mortality in China, 2022. Zhonghua Zhong Liu Za Zhi, 2024, 46(3): 221-231.
3. 王昭珏, 赵静, 王孟昭. 孤立性肺结节恶性概率预测模型的研究进展及临床应用. 中国肺癌杂志, 2021, 24(9): 660-667.Wang ZJ, Zhao J, Wang MZ. Advances and clinical application of malignant probability prediction models for solitary pulmonary nodule. Chin J Lung Cancer, 2021, 24(9): 660-667.
4. 中国中西医结合学会肿瘤专业委员会北京中医药学会, 肿瘤专业委员会, 肺结节全程管理共识专家组. 肺结节中西医结合全程管理专家共识. 中国实验方剂学杂志, 2024, 30(1): 149-159.Expert Group on Whole-Process Management of Pulmonary Nodules of the Cancer Committee of Chinese Association of Integrative Medicine, Cancer Committee of Beijing Association of Chinese Medicine. Expert consensus on whole-process management of pulmonary nodules with integrated traditional chinese and western medicine. Chin J Exper Trad Med Form, 2024, 30(1): 149-159.
5. McWilliams A, Tammemagi MC, Mayo JR, et al. Probability of cancer in pulmonary nodules detected on first screening CT. N Engl J Med, 2013, 369(10): 910-919.
6. Siegelman SS, Zerhouni EA, Leo FP, et al. CT of the solitary pulmonary nodule. AJR Am J Roentgenol, 1980, 135(1): 1-13.
7. Chen H, Kim AW, Hsin M, et al. The 2023 American Association for Thoracic Surgery (AATS) expert consensus document: Management of subsolid lung nodules. J Thorac Cardiovasc Surg, 2024, S0022-5223(24): 00361-1.
8. 谢辉辉, 王霄英, 林祥涛, 等. 人工智能软件对胸部CT肺结节检出的辅助效果初探. 医学影像学杂志, 2022, 32(6): 944-948.Xie HH, Wang XY, Lin XT, et al. Performance of artificial intelligence-assisteddetection of lung nodules on chest CT: A preliminary study. J Med Imaging, 2022, 32(6): 944-948.
9. 刘亚斌, 周围, 白琛, 等. 基于人工智能技术的肺部CT扫描在肺结节筛查及良恶性鉴别诊断中的应用分析. 中国CT和MRI杂志, 2022, 20(9): 52-54.Liu YB, Zhou W, Bai C, et al. Application of lung CT scan based on artificial intelligence technology in lung nodule screening and benign and malignant differential diagnosis. Chin J CT MRI, 2022, 20(9): 52-54.
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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Chinese thoracic surgery expert consensus on rational diagnosis and treatment of pulmonary nodules with a diameter≤2 cm (2024)

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