Surgical treatment is one of the key approaches for non-small cell lung cancer (NSCLC). Regular postoperative follow-up is crucial for early detection and timely management of tumor recurrence, metastasis, or second primary tumors. A scientifically sound and reasonable follow-up strategy not only extends patient survival but also significantly improves quality of life, thereby enhancing overall prognosis. This consensus aims to build upon the previous version by incorporating the latest clinical research advancements and refining postoperative follow-up protocols for early-stage NSCLC patients based on different treatment modalities. It provides a scientific and practical reference for clinicians involved in the postoperative follow-up management of NSCLC. By optimizing follow-up strategies, this consensus seeks to promote the standardization and normalization of lung cancer diagnosis and treatment in China, helping more patients receive high-quality care and long-term management. Additionally, the release of this consensus is expected to provide insights for related research and clinical practice both domestically and internationally, driving continuous development and innovation in the field of postoperative management for NSCLC.

With the widespread adoption of low-dose CT screening and the extensive application of high-resolution CT, the detection rate of sub-centimeter lung nodules has significantly increased. How to scientifically manage these nodules while avoiding overtreatment and diagnostic delays has become an important clinical issue. Among them, lung nodules with a consolidation tumor ratio less than 0.25, dominated by ground-glass shadows, are particularly worthy of attention. The therapeutic challenge for this group is how to achieve precise and complete resection of nodules during surgery while maximizing the preservation of the patient's lung function. The "watershed topography map" is a new technology based on big data and artificial intelligence algorithms. This method uses Dicom data from conventional dose CT scans, combined with microscopic (22-24 levels) capillary network anatomical watershed features, to generate high-precision simulated natural segmentation planes of lung sub-segments through specific textures and forms. This technology forms fluorescent watershed boundaries on the lung surface, which highly fit the actual lung anatomical structure. By analyzing the adjacent relationship between the nodule and the watershed boundary, real-time, visually accurate positioning of the nodule can be achieved. This innovative technology provides a new solution for the intraoperative positioning and resection of lung nodules. This consensus was led by four major domestic societies, jointly with expert teams in related fields, oriented to clinical practical needs, referring to domestic and foreign guidelines and consensus, and finally formed after multiple rounds of consultation, discussion, and voting. The main content covers the theoretical basis of the "watershed topography map" technology, indications, operation procedures, surgical planning details, and postoperative evaluation standards, aiming to provide scientific guidance and exploration directions for clinical peers who are currently or plan to carry out lung nodule resection using the fluorescent microscope watershed analysis method.

Objective To investigate the prognostic role of serum beta 2-microglobulin(β2M)as a systemic inflammatory biomarker in hospitalized patients with exacerbation of COPD,compared with other inflammatory biomarkers.Methods We retrospectively analyzed hospitalized patients with exacerbated COPD as the first diagnosis at Beijing Chao-Yang hospital,P.R.China,from December 31,2012 to December 28,2017.Serum β2M levels,laboratory and clinical indexes were measured or collected on admission,and all patients were followed up for 90 days.The prognostic performance of β2M was compared with the neutrophils-lymphocytes ratio(NLR),C-reactive protein values(CRP)and white blood cell(WBC)using MedCalc.Results For 30-day mortality,β2M,NLR,and CRP showed significant predictive value(all P<0.001)and were better than WBC(P=0.044,0.003 and 0.030,respectively)in hospitalized patients with exacerbated COPD,while WBC had no predictive significance.For 90-day mortality,β2M,NLR,CRP,and WBC were all statistically significant,but only NLR outperformed WBC(P=0.004).No significant differences were observed among β2M,NLR,and CRP.Conclusion As a systemic inflammatory biomarker,serum β2M was a useful prognostic biomarker for short-term death in hospitalized patients with COPD exacerbations.It performed slightly better than NLR and CRP for 30-day mortality prediction and slightly superior to CRP and slightly inferior to NLR for 90-day mortality prediction.

Objective To investigate the prognostic role of serum beta 2-microglobulin(β2M)as a systemic inflammatory biomarker in hospitalized patients with exacerbation of COPD,compared with other inflammatory biomarkers.Methods We retrospectively analyzed hospitalized patients with exacerbated COPD as the first diagnosis at Beijing Chao-Yang hospital,P.R.China,from December 31,2012 to December 28,2017.Serum β2M levels,laboratory and clinical indexes were measured or collected on admission,and all patients were followed up for 90 days.The prognostic performance of β2M was compared with the neutrophils-lymphocytes ratio(NLR),C-reactive protein values(CRP)and white blood cell(WBC)using MedCalc.Results For 30-day mortality,β2M,NLR,and CRP showed significant predictive value(all P<0.001)and were better than WBC(P=0.044,0.003 and 0.030,respectively)in hospitalized patients with exacerbated COPD,while WBC had no predictive significance.For 90-day mortality,β2M,NLR,CRP,and WBC were all statistically significant,but only NLR outperformed WBC(P=0.004).No significant differences were observed among β2M,NLR,and CRP.Conclusion As a systemic inflammatory biomarker,serum β2M was a useful prognostic biomarker for short-term death in hospitalized patients with COPD exacerbations.It performed slightly better than NLR and CRP for 30-day mortality prediction and slightly superior to CRP and slightly inferior to NLR for 90-day mortality prediction.

BACKGROUND: Perioperative treatment has become an increasingly important aspect of the management of patients with non-small cell lung cancer (NSCLC). Small-scale clinical studies performed in recent years have shown improvements in the major pathological remission rate after neoadjuvant therapy, suggesting that it will soon become an important part of NSCLC treatment. Nevertheless, neoadjuvant immunotherapy may be accompanied by serious adverse reactions that lead to delay or cancelation of surgery, additional illness, and even death, and have therefore attracted much attention. The purpose of the clinical recommendations is to form a diagnosis and treatment plan suitable for the current domestic medical situation for the immune-related adverse event (irAE). METHODS: This recommendation is composed of experts in thoracic surgery, oncologists, thoracic medicine and irAE related departments (gastroenterology, respirology, cardiology, infectious medicine, hematology, endocrinology, rheumatology, neurology, dermatology, emergency section) to jointly complete the formulation. Experts make full reference to the irAE guidelines, large-scale clinical research data published by thoracic surgery, and the clinical experience of domestic doctors and publicly published cases, and repeated discussions in multiple disciplines to form this recommendation for perioperative irAE. RESULTS: This clinical recommendation covers the whole process of prevention, evaluation, examination, treatment and monitoring related to irAE, so as to guide the clinical work comprehensively and effectively. CONCLUSIONS Perioperative irAE management is an important part of immune perioperative treatment of lung cancer. With the continuous development of immune perioperative treatment, more research is needed in the future to optimize the diagnosis and treatment of perioperative irAE.

Resection is crucial for treating non-small cell lung cancer. Routine follow-up after surgery is an effective method for early detection and treatment of tumor recurrence and metastasis or the second primary tumor, which can improve the quality of life of patients and their prognosis. This consensus aims to provide a reference for colleagues responsible for postoperative follow-up of non-small cell lung cancer patients in China, and further improve the standardization of lung cancer diagnosis and treatment.

Objective: To investigate whether elevated levels of C-reactive protein (CRP) and neutrophil (NE) in the blood is associated with an increased risk of lung cancer incidence. Methods: From 2006 to 2007, all employees and retirees from Kailuan (Group) Limited liability Corporation were included in this Kailuan Cohort study. The last follow-up date was December 2015. Data on new cases of lung cancer were collected, and multivariable Cox proportional hazards regression models were used to the relationship between baseline CRP and NE at baseline and risk of lung cancer. Results: A total of 92 735 participants were enrolled in this study. During the follow-up, 850 new cases of lung cancer were identified. All subjects were divided into four groups according to the combination level of CRP and NE at baseline: CRP≤3 mg/L and NE≤4×10⁹/L(Group A), CRP≤3 mg/L and NE>4×10⁹/L(Group B), CRP>3 mg/L and NE≤4×10⁹/L(Group C), CRP>3 mg/L and NE>4×10⁹/L(Group D). The cumulative incidence of lung cancer were 950/100 000, 1 030/100 000, 1 081/100 000 and 1 596/100 000 in these four groups, respectively (P<0.001). Multivariate Cox proportional risk model showed that participants from Group D had an significantly increased 72% risks of lung cancer when compared to Group A (95% CI: 1.40~2.12, P<0.001). Stratified analyses gender showed that males in Group D had higher risk of lung cancer when compared with participants in Group A (HR=1.73, 95% CI: 1.40~2.15, P<0.001). Conclusion Elevated levels of CRP and NE might increase the risk of lung cancer.

Objective To investigate whether elevated levels of C?reactive protein ( CRP ) and neutrophil (NE) in the blood is associated with an increased risk of lung cancer incidence. Methods From 2006 to 2007, all employees and retirees from Kailuan (Group) Limited liability Corporation were included in this Kailuan Cohort study. The last follow?up date was December 2015. Data on new cases of lung cancer were collected, and multivariable Cox proportional hazards regression models were used to the relationship between baseline CRP and NE at baseline and risk of lung cancer. Results A total of 92 735 participants were enrolled in this study. During the follow?up, 850 new cases of lung cancer were identified. All subjects were divided into four groups according to the combination level of CRP and NE at baseline: CRP≤3 mg／L and NE≤4×109／L(Group A), CRP≤3 mg／L and NE＞4×109／L( Group B), CRP＞3 mg／L and NE≤4× 109／L(Group C), CRP＞3 mg／L and NE＞4×109／L(Group D). The cumulative incidence of lung cancer were 950／100 000, 1 030／100 000, 1 081／100 000 and 1 596／100 000 in these four groups, respectively (P＜0.001 ). Multivariate Cox proportional risk model showed that participants from Group D had an significantly increased 72% risks of lung cancer when compared to Group A ( 95% CI: 1.40～2.12, P＜0.001). Stratified analyses gender showed that males in Group D had higher risk of lung cancer when compared with participants in Group A (HR＝1.73, 95% CI: 1.40～2.15,P＜0.001).Conclusion Elevated levels of CRP and NE might increase the risk of lung cancer.

Objective To investigate whether elevated levels of C?reactive protein ( CRP ) and neutrophil (NE) in the blood is associated with an increased risk of lung cancer incidence. Methods From 2006 to 2007, all employees and retirees from Kailuan (Group) Limited liability Corporation were included in this Kailuan Cohort study. The last follow?up date was December 2015. Data on new cases of lung cancer were collected, and multivariable Cox proportional hazards regression models were used to the relationship between baseline CRP and NE at baseline and risk of lung cancer. Results A total of 92 735 participants were enrolled in this study. During the follow?up, 850 new cases of lung cancer were identified. All subjects were divided into four groups according to the combination level of CRP and NE at baseline: CRP≤3 mg／L and NE≤4×109／L(Group A), CRP≤3 mg／L and NE＞4×109／L( Group B), CRP＞3 mg／L and NE≤4× 109／L(Group C), CRP＞3 mg／L and NE＞4×109／L(Group D). The cumulative incidence of lung cancer were 950／100 000, 1 030／100 000, 1 081／100 000 and 1 596／100 000 in these four groups, respectively (P＜0.001 ). Multivariate Cox proportional risk model showed that participants from Group D had an significantly increased 72% risks of lung cancer when compared to Group A ( 95% CI: 1.40～2.12, P＜0.001). Stratified analyses gender showed that males in Group D had higher risk of lung cancer when compared with participants in Group A (HR＝1.73, 95% CI: 1.40～2.15,P＜0.001).Conclusion Elevated levels of CRP and NE might increase the risk of lung cancer.