電腦斷層下肺部結節之處置建議

Management of Pulmonary Nodules Detected on CT Image

王保山(Pao-Shan Wang) ； 鄭高珍(Kuo-Chen Cheng)

《內科學誌》 29卷3期 (2018/06) Pp. 137-142

https://doi.org/10.6314/JIMT.201806_29(3).03

摘要

肺癌在台灣及全世界皆為癌症死亡率之首。診斷肺癌時的分期，為影響病人預後的重要因素。然而肺癌早期大多無症狀，一旦出現症狀而診斷肺癌時，多數為局部晚期或已發生遠端轉移，而無法以手術切除治癒。因此若能早期偵測肺癌，早期治療，將可降低肺癌死亡率。電腦斷層檢查可用來偵測及評估肺部結節。然而，電腦斷層檢查偵測到的肺部小結節，大多數不是腫瘤。因此，如何針對電腦斷層檢查的結果，做出進一步的處置建議，是目前重要的議題。本文將介紹Fleischner Society 2017年指引及Lung-RADS報告系統，做為電腦斷層下肺部結節之處置建議依據。

關鍵字

肺癌(Lung cancer) ； 電腦斷層(Computed tomography) ； 實質結節(Solid nodule) ； 亞實質結節(Subsolid nodule)

並列摘要

Lung cancer is the leading cause of cancer-related death in Taiwan and worldwide. Clinical outcome for lung cancer is directly related to stage at the time of diagnosis. However, most lung cancers have already spread widely and are at an advanced stage and unable to resection by surgical intervention when they are first diagnosed. Early detection of lung cancer is an important factor for decreasing mortality. Computed tomography (CT) is an important tool in the evaluation of pulmonary nodules. However, most small lung nodules seen on CT scans are not cancer. The important issue is how to make further suggestion of management after detection of pulmonary nodules by CT scans. In this article, we will focus on the guidelines from Fleischner Society 2017 and Lung-RADS for management of pulmonary nodules detected on CT image.