Is a lung nodule lung cancer? Does it require surgery?

With the popularization of lung CT examinations in health examinations, more and more lung nodules are being discovered.

Many people will worry: Is lung nodule lung cancer? !

First of all, we need to make it clear that not all lung nodules are lung cancer, but the early manifestation of lung cancer is often lung nodules. Just as a certain advertisement says, not all milk is Deluxe, but Deluxe is milk before it is produced.

Moreover, studies have shown that more than 90% of lung nodules are benign. Therefore, when you find a lung nodule, you don’t need to worry too much. At this time, you need a professional doctor to evaluate it. The doctor will tell you which lung nodules can be checked regularly and which ones need to be removed immediately!

Definition of pulmonary nodules: pulmonary lesions with a diameter ≤ 30 mm.

There are many causes of pulmonary nodules, such as lung infection, primary or metastatic lung tumors, and benign lung lesions can all manifest as pulmonary nodules.

Pulmonary nodule classification:

Lesions are divided into nodules and masses according to their diameter:

① A diameter of less than 5 mm is considered a micronodule;

②A small nodule has a diameter of 5 to 10 mm;

③A nodule is 10 to 30 mm in diameter;

④ A lung mass is one with a diameter greater than 30 mm.

There is no doubt that lung masses need to be removed immediately and without delay.

Pulmonary nodules with a diameter between 10-30 mm:
This type of lung nodule is most likely early lung cancer and should be surgically removed. If the postoperative pathology report suggests lung cancer, most patients can achieve a radical cure.

Even if the removed nodule is benign, surgery is not considered overtreatment, because some diseases, such as special lung infections, also require timely surgical treatment when the size of the lesion exceeds 1 cm.

Pulmonary nodules with a diameter between 8-10 mm:
This type of lung nodule may be early lung cancer. Further high-resolution enhanced CT or PET-CT examination of the lungs is recommended.

If CT scans are highly suggestive of lung malignancy, surgical resection is necessary;

If the CT scan highly suggests a high probability of benign disease, it is recommended to observe for 3 months, because some lung nodules can indeed disappear after empirical anti-inflammatory treatment or observation. If the diameter of the lung nodule becomes smaller after 3-month follow-up and there are no other obvious changes, it is recommended to review the lung CT scan every 6 months.

If the diameter of the lung nodule becomes significantly larger after a follow-up examination 3 months later, or if the CT signs show malignant signs such as spiculation, lobulation, and pleural indentation, or if the solid component increases, surgical resection should be considered.

Compared with the growth rate of lung malignant tumors, the three-month observation period will not delay treatment.

Lung nodules with a diameter of 6-8mm are less likely to be early lung cancer, so there is no need to panic. It is recommended to have a lung CT scan again after 6 months.

If the diameter of the lung nodule becomes smaller and there are no other obvious changes after the 6-month follow-up examination, it is recommended to have a lung CT examination once a year in the future.

If the diameter of the lung nodule becomes larger after a follow-up examination 6 months later, or if the CT signs show malignant signs such as spiculation, lobulation, and pleural indentation, or if the solid component increases, surgical resection should be considered.

Lung nodules with a diameter of 4-6 mm are less likely to be early lung cancer. There is no need to feel psychologically stressed. It is recommended to have a lung CT scan again after 12 months.

If the diameter of the lung nodule becomes smaller and there are no other obvious changes after the 12-month follow-up, lung CT examination can be performed once a year thereafter.

If the diameter of the lung nodule becomes significantly larger after the 12-month follow-up, or if the CT signs show malignant signs such as spicule sign, lobulation sign, pleural indentation sign, or the solid component increases, surgical resection should be considered. (At this time, even if it is confirmed to be lung cancer after surgery, the degree of harm to the body is very small, and the purpose of radical cure of lung cancer can be achieved).

Pulmonary nodules with a diameter between 1 and 4 mm

The possibility that this type of lung nodule is early lung cancer is extremely low, so there is no need to worry at all. A lung CT scan once a year is sufficient.

Lung cancer gene testing: When lung nodules are found in lung CT and early lung cancer cannot be ruled out after evaluation by clinical specialists, lung cancer gene testing technology can provide useful guidance.

Lung cancer gene testing can predict and assess an individual's risk of developing lung cancer, and is of great reference value for screening early lung cancer. Due to the relatively high price of gene testing, it is not suitable as a routine physical examination item, but lung cancer gene testing is recommended for the following three groups of people:

① A family member was diagnosed with lung cancer at a very young age;

② There are multiple first-degree relatives in the family suffering from lung cancer;

③The lung cancer suffered by family members is related to the same gene mutation.

If you or your family or friends meet any one or more of the above three conditions, regardless of whether you have a history of lung nodules or not, it is recommended that you undergo lung cancer gene testing. In addition to assessing the risk of lung cancer, the test results can also provide cancer prevention recommendations to prevent the occurrence of lung cancer to the greatest extent possible.