周小昀;梁乃新;李单青;
ZHOU Xiao-yun;LIANG Nai-xin;LI Shan-qing;Department of General Thoracic Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

• 1:中国医学科学院北京协和医学院北京协和医院胸外科

摘要(Abstract)：

以肺磨玻璃病灶为表现的多原发肺癌的发病率呈逐年上升趋势。该类疾病发生发展与经典肺癌有所不同,其发病原因及治疗策略受到胸外科医师及患者的密切关注。本文记录了北京胸外科青年医师基于一例双肺多灶磨玻璃病变诊疗策略开展的讨论过程,集中反映了本病诊治的关键点和人文思考。
Patients with multiple pulmonary ground-glass nodules become more common in the clinic nowadays. Pathogenesis and progression of this kind of disease are strikingly different from those of typical malignant lung tumors. Management strategy of it has been hotly discussed. Here we present a case of bilateral multiple pulmonary ground-glass nodules and the following discussion among young thoracic surgeons in Beijing.

关键词(KeyWords)： 肺磨玻璃病变;多原发肺癌;肺切除术
pulmonary ground glass nodule;multiple pulmonary lung cancer;thoracic surgery for lung cancer

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 周小昀;梁乃新;李单青;
ZHOU Xiao-yun;LIANG Nai-xin;LI Shan-qing;Department of General Thoracic Surgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;

参考文献(References)：

• [1]Martini N,Melamed MR.Multiple primary lung cancers[J].J Thorac Cardiov Surg,1975,70:606-612.
• [2]Xue X,Liu Y,Pan L,et al.Diagnosis of multiple primary lung cancer:a systematic review[J].J Int Med Res,2013,41:1779-1787.
• [3]Jiang L,He J,Shi X,et al.Prognosis of synchronous and metachronous multiple primary lung cancers:Systematic review and meta-analysis[J].Lung Cancer,2015,87:303-310.
• [4]Takamochi K,Oh S,Matsuoka J,et al.Clonality status of multifocal lung adenocarcinomas based on the mutation patterns of EGFR and K-ras[J].Lung Cancer,2012,75:313-320.
• [5]Kozower BD,Larner JF,Detterbeck DR,et al.Special treatment issues in non-small cell lung cancer:Diagnosis and management of lung cancer,3rd ed:American College of Chest Physicians evidence-based clinical practice guidelines[J].Chest,2013,143:369-399.
• [6]Matthiesen C,Thompson JS,De LF,et al.Use of stereotactic body radiation therapy for medically inoperable multiple primary lung cancer[J].J Med Imaging Radiat Oncol,2012,56:561-566.
• [7]宁晖,姜格宁,王海峰,等.p53、HER2、K-ras在多原发肺癌中的表达及临床意义[J].中华胸心血管外科杂志,2011,27:483-484.
• [8]Wu CT,Lin MW,Hsieh MS,et al.New aspects of the clinicopathology and genetic profile of metachronous multiple lung cancers[J].Ann Surg,2014,259:1018-1024.
• [9]Yang H,Sun Y,Yao F,et al.Surgical therapy for bilateral multiple primary lung cancer[J].Ann Thorac Surg,2016,101:1145-1152.
• [10]Koezuka S,Hata Y,Otsuka H,et al.Metachronous second primary lung cancer surgically treated five years or more after the initial surgery[J].Mol Clin Oncol,2015,3:1025-1028.
• [11]Tsunezuka Y,Matsumoto I,Tamura M,et al.The results of therapy for bilateral multiple primary lung cancers:30 years experience in a single centre[J].Eur J Surg Oncol,2004,30:781-785.
• [12]Kim HK,Choi YF,Kim KF,et al.Management of groundglass opacity lesions detected in patients with otherwise operable non-small cell lung cancer[J].J Thorac Oncol,2009,4:1242-1246.
• [13]Trousse D,Barlesi FF,Loundou AF,et al.Synchronous multiple primary lung cancer:an increasing clinical occurrence requiring multidisciplinary management[J].J Thorac Cardiovasc Surg,2007,133:1193-1200.