Risk assessment and stepwise management framework for pulmonary nodules
- VernacularTitle:肺结节风险评估与阶梯式管理框架
- Author:
Lang TANG
1
,
2
;
Xiaoke CHEN
2
;
Jie TANG
2
;
Jin JIANG
2
;
Xinnan FANG
2
;
Sikun LIU
2
;
Zeguang YE
2
;
Jiamei JIN
2
;
Canglei ZHANG
2
;
Wenzhao ZHONG
3
;
Haibo WANG
4
;
Yi HU
5
;
Hao ZHANG
6
;
Jigang DAI
7
;
Guibin QIAO
8
;
Junqiang FAN
2
Author Information
1. Bengbu Medical University, Bengbu, 233030, Anhui, P. R. China
2. Department of Thoracic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, P. R. China
3. Department of Thoracic Surgery, Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, P. R. China
4. Center for Medical Big Data and Artificial Intelligence, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, P. R. China
5. Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing, 100039, P. R. China
6. Department of Thoracic Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221006, Jiangsu, P. R. China
7. Department of Thoracic Surgery, The Second Affiliated Hospital of Third Military Medical University, Chongqing, 630037, P. R. China
8. Department of Thoracic Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, P. R. China
- Publication Type:Journal Article
- Keywords:
Pulmonary nodule;
risk assessment;
stepwise management;
multidisciplinary collaboration;
clinical decision-making
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2026;33(10):1544-1552
- CountryChina
- Language:Chinese
-
Abstract:
Objective To propose a framework for risk assessment and stepwise management of pulmonary nodules based on existing guidelines and key studies, and to clarify the boundaries for triage, workup escalation, and referral in different detection scenarios. Methods A problem-oriented evidence synthesis approach was used, prioritizing Chinese expert consensus, Fleischner Society Guidelines, British Thoracic Society (BTS) Guidelines, and Lung-RADS. This was supplemented by studies on risk models, imaging measurements, liquid biopsy, tissue sampling, and surgical treatments. This paper is not presented as a formal consensus or a validated clinical pathway. Results A three-tiered framework consisting of basic non-invasive assessment, advanced assessment, and invasive diagnosis was established. It specified the applicable populations, boundaries for the use of risk models, imaging review, management of conflicting results, evaluation of histopathological consistency, and post-intervention follow-up. Liquid biopsy, genetic testing, and artificial intelligence were defined as investigational or adjunctive tools. Conclusion This framework can serve as a preliminary reference for multidisciplinary teams in developing local protocols. It cannot replace applicable guidelines, pathological diagnosis, shared decision-making with patients, or real-world validation.
