孤立性肺结节是指肺内直径 <3 cm、完全由肺实质包绕的类圆形病变。与肺内肿块不同，后者直径 >3 cm。传统地，孤立性肺结节也不包括计算机体层成像 (CT) 扫描上显示的磨玻璃样浸润病变，因为磨玻璃样浸润通常与支气管肺泡细胞癌相关且不符合结节的物理特性。 在本主题中，我们将磨玻璃样阴影归为孤立性肺结节的一种。
对孤立性肺结节而言，确定临床特征（如患者年龄、吸烟状况）和影像学特征（如钙化、生长速度、大小）有助于判断恶性结节的可能性。 如果有必要，可行无创和/或有创检查以更准确地判断恶性结节的可能性并据此决定应对患者进行观察随访还是手术切除病灶。 因此，选择合适的检查方法前需充分了解这些检查方法的特性。 应用Bayesian定理的决策分析方法也有助于计算恶性概率，虽然这些方法并非总是优于临床评估和检测方法。
Erik E. Folch, MD, MSc
Chief, Complex Chest Disease Center
Co-director, Interventional Pulmonology Massachusetts General Hospital
Harvard Medical School
EEF is the global principal investigator for the NAVIGATE trial, sponsored by Medtronic. He has also served as scientific consultant for Boston Scientific in the development of advanced bronchoscopic techniques.
Peter J. Mazzone, MD, MPH, FCCP
Director of Lung Cancer Program
Director of Lung Cancer Screening Program
Director of Education
PJM has been paid to participate in clinical advisory board meetings for Oncimmune, InDi, Nucleix, Grail, and Oncocytelooking, all companies interested in developing molecular biomarkers for the evaluation of lung nodules/ lung cancer; he does not have a contractual agreement to disseminate product information for any of these companies. PJM has participated in research supported by InDi Veracyte, that was paid to his institution. He has also participated in research with in-kind support from Oncimmune and 20/20 Genesystems.
Pallav L. Shah, MD, MBBS, FRCP
Royal Brompton Hospital
Chelsea & Westminster Hospital
PLS declares that he has no competing interests.
Sangeeta M. Bhorade, MD
Associate Professor of Medicine
Lung Transplant Program
University of Chicago Hospitals
SMB declares that she has no competing interests.