{"title":"[中华医学会肺癌临床诊治指南(2024 年版)》。]","authors":"","doi":"10.3760/cma.j.cn112152-20240510-00189","DOIUrl":null,"url":null,"abstract":"<p><p>To further standardize lung cancer prevention and treatment measures in China, enhance the quality of diagnosis and treatment, improve patient prognosis, and provide evidence-based medical guidance for clinicians at all levels, the Chinese Medical Association convened experts from respiratory medicine, oncology, thoracic surgery, radiotherapy, imaging, and pathology to develop the Chinese Medical Association's Clinical Diagnosis and Treatment Guidelines for Lung Cancer (2024 edition). This consensus resulted in several updates from the 2023 version. The 2024 guidelines highlight that the risk of lung cancer in smokers remains higher than that of non-smokers even 15 years after quitting. Additionally, a new lung cancer incidence risk model is expected to become a critical tool for screening high-risk groups. In pathology, the guidelines now include pathological evaluation of surgically resected lung cancer specimens following neoadjuvant therapy and suggest that immunohistochemical staining of certain transcription factors may aid in the classification of small cell lung cancer (SCLC). In molecular detection, the guidelines propose simultaneous detection of driver gene variations based on both RNA and DNA from specimens. The new edition also provides detailed descriptions of patient selection and surgical requirements for thoracic sub-lobectomy, aligned with the 9th TNM staging. Moreover, the guidelines expand treatment options, approving more therapies for immunoadjuvant and EGFR-TKI resistant lung cancer patients, as well as additional drug options for advanced non-small cell lung cancer (NSCLC) patients with EGFR mutations, EGFR 20 insertions, ALK fusions, and MET exon 14 skipping. These recommendations are based on state-approved drug applications, international guidelines, and current clinical practices in China, integrating the latest evidence-based medical research in screening, diagnosis, pathology, genetic testing, immune molecular marker detection, treatment methods, and follow-up care. The goal is to provide comprehensive and reasonable recommendations for clinicians, imaging specialists, laboratory technicians, rehabilitation professionals, and other medical staff at all levels.</p>","PeriodicalId":39868,"journal":{"name":"中华肿瘤杂志","volume":"46 ","pages":"805-843"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2024 edition)].\",\"authors\":\"\",\"doi\":\"10.3760/cma.j.cn112152-20240510-00189\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>To further standardize lung cancer prevention and treatment measures in China, enhance the quality of diagnosis and treatment, improve patient prognosis, and provide evidence-based medical guidance for clinicians at all levels, the Chinese Medical Association convened experts from respiratory medicine, oncology, thoracic surgery, radiotherapy, imaging, and pathology to develop the Chinese Medical Association's Clinical Diagnosis and Treatment Guidelines for Lung Cancer (2024 edition). 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引用次数: 0
摘要
为进一步规范我国肺癌防治措施,提高诊疗质量,改善患者预后,为各级临床医师提供循证医学指导,中华医学会召集呼吸内科、肿瘤科、胸外科、放疗科、影像科、病理科等科室专家,制定了《中华医学会肺癌临床诊疗指南(2024年版)》。这一共识在 2023 年版的基础上进行了多项更新。2024 年版指南强调,即使在戒烟 15 年后,吸烟者罹患肺癌的风险仍高于非吸烟者。此外,新的肺癌发病风险模型有望成为筛查高危人群的重要工具。在病理学方面,指南新增了对新辅助治疗后手术切除的肺癌标本进行病理学评估的内容,并建议对某些转录因子进行免疫组化染色,以帮助对小细胞肺癌(SCLC)进行分类。在分子检测方面,指南建议根据标本中的 RNA 和 DNA 同时检测驱动基因变异。新版指南还详细介绍了胸腔下叶切除术的患者选择和手术要求,并与第9版TNM分期保持一致。此外,指南还扩大了治疗选择范围,批准了更多针对免疫佐剂和表皮生长因子受体-TKI耐药肺癌患者的疗法,以及针对表皮生长因子受体突变、表皮生长因子受体20插入、ALK融合和MET外显子14跳越的晚期非小细胞肺癌(NSCLC)患者的更多药物选择。这些建议基于国家批准的药物申请、国际指南和中国目前的临床实践,整合了筛查、诊断、病理、基因检测、免疫分子标记物检测、治疗方法和随访护理等方面的最新循证医学研究。目的是为临床医生、影像学专家、实验室技术人员、康复专业人员和其他各级医务人员提供全面合理的建议。
[Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2024 edition)].
To further standardize lung cancer prevention and treatment measures in China, enhance the quality of diagnosis and treatment, improve patient prognosis, and provide evidence-based medical guidance for clinicians at all levels, the Chinese Medical Association convened experts from respiratory medicine, oncology, thoracic surgery, radiotherapy, imaging, and pathology to develop the Chinese Medical Association's Clinical Diagnosis and Treatment Guidelines for Lung Cancer (2024 edition). This consensus resulted in several updates from the 2023 version. The 2024 guidelines highlight that the risk of lung cancer in smokers remains higher than that of non-smokers even 15 years after quitting. Additionally, a new lung cancer incidence risk model is expected to become a critical tool for screening high-risk groups. In pathology, the guidelines now include pathological evaluation of surgically resected lung cancer specimens following neoadjuvant therapy and suggest that immunohistochemical staining of certain transcription factors may aid in the classification of small cell lung cancer (SCLC). In molecular detection, the guidelines propose simultaneous detection of driver gene variations based on both RNA and DNA from specimens. The new edition also provides detailed descriptions of patient selection and surgical requirements for thoracic sub-lobectomy, aligned with the 9th TNM staging. Moreover, the guidelines expand treatment options, approving more therapies for immunoadjuvant and EGFR-TKI resistant lung cancer patients, as well as additional drug options for advanced non-small cell lung cancer (NSCLC) patients with EGFR mutations, EGFR 20 insertions, ALK fusions, and MET exon 14 skipping. These recommendations are based on state-approved drug applications, international guidelines, and current clinical practices in China, integrating the latest evidence-based medical research in screening, diagnosis, pathology, genetic testing, immune molecular marker detection, treatment methods, and follow-up care. The goal is to provide comprehensive and reasonable recommendations for clinicians, imaging specialists, laboratory technicians, rehabilitation professionals, and other medical staff at all levels.