2023 年第 10 期 第 18 卷

恶性肿瘤中多发性肺结节诊断及病理的研究进展

Research progress on multiple pulmonary nodules in malignant tumors

作者：王运黄剑

英文作者：Wang Yun Huang Jian

单位：广东医科大学附属医院病理诊断与研究中心，湛江524001

英文单位：Pathological Diagnosis and Research Center Affiliated Hospital of Guangdong Medical University Zhanjiang 524001 China

关键词：恶性肿瘤；多发性肺结节；转移；免疫微环境

英文关键词：Malignanttumor;Multiplepulmonarynodules;Metastasis;Immunemicroenvironment

• 摘要：

• 随着胸部低剂量螺旋CT在常规体检中的广泛应用，越来越多的多发性肺结节被检出。多发性肺结节的存在可能提示着良、恶性病变共存，且不同性质肺结节的起源、演变过程及对治疗的反应性亦不同。近年来，免疫治疗为难治性肺癌带来了突破性的进展，但不同性质的肺癌，可能因其免疫微环境的不同以及其属原发或转移问题，造成免疫治疗效果不佳。本文综述了恶性多发性肺结节的起源、不同病理状态下肺癌的免疫微环境、肺结节的进展及指导性治疗。

• With the wide application of low-dose co-dose spiral CT in routine physical examinations, more and more multiple lung nodules have been detected. The existence of multiple pulmonary nodules may indicate the coexistence of benign and malignant lesions, and the origin, evolution and responsiveness of pulmonary nodules of different properties are also different. In recent years, immunotherapy has brought breakthrough progress to refractory lung cancer, but lung cancer of different natures may have poor immunotherapy due to its different immune microenvironment and primary or metastasis. This article reviews the origin of malignant multiple pulmonary nodules and the immune microenvironment of lung cancer under different pathological conditions, the progression of malignant pulmonary nodules and guiding treatment.