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20182015[1][1][2][3,4,5,6,7]CT[1,2,3,4,5]3cm3cm103cm[1,2,3,4,5]1225mm,5~10mm10~30mm3[1,2,3,4,5]1solidnodule2subsolidnoduleCTpureground-classnodulepGGNmixedground-glassnodulemGGNpartsolidnodulepGGNmGGN[1,2,3,4,5,6,7,8,9]2011NationalLungScreeningTrialNLSTXCT20%[8]CT[9]NationalComprehensiveCancerNetwork,NCCNAmericanCollegeofChestPhysicians,ACCP[3,6]CT[9]40120400204001523412[1,2,3,4,5,6,9]X1cmXXXCTCT1C1mmCTCT11.0mSvkVp120mAs400.51.5mm5mm1mm3D50%210sCT163[1,10][10]1progastrinreleasingpeptidePro-GRP2neuronespecificenolaseNSE3carcino-embryonicantigen,CEACEA419cytokeratinfragmentCYFRA21-15squarmouscellcarcinomaantigenSCC4[1,2,3,4]8mm-PET-CT[11]PET-CTpGGN8mm[12]8mmPET-CT1818F-FDG18F-FDG18F-FDGstandardizeduptakevalueSUVPET-CTSUV2.5PET-CT72%~94%[3]PET-CTCT[3]5~40mmCT15HU98%58%[13]5[3]1transbronchiallungbiopsy,TBLBautofluorescencebronchoscopyAFBEBUS-TBLBEBUS-TBLBTBLBEBUS-TBLB20mm71%TBLB23%[14]virtualbronchoscopicnavigation,VBN[15]CTVBN5~8electromagneticnavigationbronchoscopyENB[16,17]EBUSVBNENB[15]EBUSENBVBN70%20mm61%20mm82%EBUSENB82.5%[18]2transthoracicneedlebiopsyTTNB[3]CT[19,20]CT61TTNB2EBUS[1,2,3,4,5][3,5]-11GGN234--GGN21[10,11]pGGN5mmpGGNatypicaladenomatoushyperplasia,AAH[21]mGGN50%[22]minimallyinvasiveadenocarcinomaMIAinvasiveadenocarcinomaIApGGNGGNGGNCT2CT1mmCT3pGGN8mm[12]8mmPET-CTCT15HU[13]4[23,24,25,26],123415d52GGNadenocarcinomainsitu,AISMIAGGN212345[3,26]1ACCPlogistic4194~30mm6OR1.04/OR2.25OR3.8OR1.14/mmOR2.8OR2.2=ex/1+exX=-6.8272+0.0391+0.7917+1.3388+0.1274+1.0407+0.7838e=1=05=1=0mm=1=0=1=0ACCP8~30mm[1,2,3,4,5]18~30mm28~30mmCT18~30mm18mm2C28mm5%~65%PET-CT2C38mm65%2C[27]PET-CT[12],[28]48mm1C58mmCT2C15%230%~40%pet-ctct158mmCT68mm3~69~1218~24CT2C1CTCT278mm[14,15,16,17,18,19,20][29,30]1C88mm2C[14,15,16,17,18,19,20]123498mm2C[29,30,31]:165%2PET-CTCT34108mm[29,30,31]1C,8mm[1,2,3,4]28mm18mmCT2C4mm4~6mm126~8mm6~1218~24CT8mmCT28mmCT2C4mm124~6mm6~1218~246~8mm3~69~1224CT8mmCT28mm3pGGN[1,2,3,4,5,6]pGGN5mm1pGGN5mm6CTCT2pGGN5mm3CTCT10mm2CpGGNCT10mmmGGN[1,2,3,4,5,6]mGGNmGGNCT1mGGN8mm361224CT1CT2342mGGN8mm3CTPET-CT2C1PET-CT8mm234mGGN15mmPET-CT36mmmGGN3~6CT8mmmGGNPET-CT,mGGN5mm[1,2,3,4,5]1122C3pGGN15mm10mm3CT31CT,,4PET-CTmmPET-CT516EBUSVBNENB710[1,2,7]A1cm[7]12:CT[1,2,3,4,5,6][7]115mm2mm215mm15%3pGGNmGGN45EBUS-TBLBVBNEBN3123155=10=10mm