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2 618 Chin J Respir Crit Care Med, November 2015, Vol. 14, No. 6 http: / /www. cjrccm. com, ), 504, 97% 3% [ 1 5],, [ 16] CT ( Solid GGN) ( Part-solid GGN) ( Pure GGN) 75%, 6%, 19% [ 17], 28. 7% < 3 cm, 2 cm60. 4% [ 18 ], 8. 5% 132 SPNs, 30%, 5. 9% [ 1 9], : [ 20], 49%,, [ 21] : d,, > 2 [ 22] d [ 23 ], ( 2) CT : < 15 HU, 20 HU,, Meta 10, 93%, 76%, ( PPV) 80%, ( NPV) 95% [ 24 ] CT, CT 8 mm ( 3) PET-CT:, PET-CT 87% 83% [ 25 ], PET-CT, PET-CT 8 10 mm [ 26] ;,, ;, ( ) ( 4) ( MRI) : MRI SPNs > 1 cm, MRI CT [ 27 ], MRI SPNs 2. :, [ 28 ] ( 2) 2 SPNs ( mm) < > 20 ( ) < > 60 - < 1 /d 1 /d 7 < : SPNs ( 1) :, 66%, 99% [ 29] ( ), SPNs,, DNA ( CEA) P53 1( ET-1) ( 2) :, CEA ( NSE) 19 ( Cyfra21-1 ) ( CA125) SPNs SPNs [ 3 0] 4. : SPNs,,,

3 http: / /www. cjrccm. com 619 ( 1) ( FOB) :, ( BB) ( BAL) ( TBLB), SPN 2 cm, 1 /3, 14% [ 31 ], SPNs ( EBUS) :,, Yamada [ 32], %,, 5, EBUS SPNs ( ENB) : ENB CT, 3D,, ENB 67% [ 33 ] ( 2) ( FNAB) :, CT, Meta, FNAB 86%, 98. 8% [ 34 ] CT 91%, 94% [ 35 ], SPNs, CT FNAB ( 3) ( VATS) : SPNs,,,, SPNs < 1 cm SPNs,, CT [ 3 6] SPNs SPNs : ( 1) CT, ; ( 2) ( CT, PET-CT,, ) ; ( 3) CT SPNs,, 0,, 1, 0 1, [ 3 7] CT PET-CT Fleischner SPNs ( 3 4) [ 38 ] Fleischner SPNs ( mm) 4 12 CT, CT, 6 12 CT, CT, CT > CT, CT PET / Fleischner SPNs 5 mm CT 1 mm > 5 mm 3 CT, CT > 3 PET, 3 CT < 5 mm, CT > 3 ; 5 mm, > 10 mm PET-CT 5 mm CT 2 4 > 5 mm 3 CT, CT > 3 PET-CT, 3 CT, > 5 mm

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