可手术肺癌分子残留病灶检测临床应用专家共识(2026版)

Expert Consensus on Clinical Application of Molecular Residual Disease Detection in Resectable Lung Cancer (2026 Edition)

  • 摘要: 基于循环肿瘤DNA的分子残留病灶(molecular residual disease, MRD)检测技术在可手术肺癌的预后评估与复发监测中极具应用价值, 但当前其在适用人群、技术路径、监测时机及适应性治疗策略等核心环节尚缺乏统一规范。为此, 中国胸部肿瘤研究协作组青年委员会成立了"可手术肺癌分子残留病灶专家共识工作组", 在系统回顾国内外前沿进展与客观循证医学证据的基础上, 制定了《可手术肺癌分子残留病灶检测临床应用专家共识(2026版)》。该共识重点围绕MRD检测的目标人群筛选、检测技术路径优选、围术期/术后纵向随访的时间节点设定, 以及基于MRD状态指导初治与接受新辅助治疗患者升阶/降阶策略的临床价值等内容进行了系统梳理与深入论述, 并明确了MRD标准化检测报告体系的构建要素, 旨在为胸外科及肿瘤内科医师临床实践提供客观的科学依据与决策参考, 以期推动可手术肺癌迈向个体化精准管理的新阶段。

     

    Abstract: Detection of molecular residual disease (MRD) based on circulating tumor DNA holds significant application value for prognostic assessment and recurrence monitoring in resectable lung cancer. However, current practices lack standardized guidelines regarding core aspects such as target populations, technical approaches, timing of monitoring, and adaptive treatment strategies. To address this, the Chinese Thoracic Oncology Group (CTONG) YOUNG established a "Working Group on Expert Consensus for Molecular Residual Disease in Resectable Lung Cancer". Based on a systematic review of the latest international advancements and objective evidence-based medical data, the group formulated the Expert Consensus on Clinical Application of Molecular Residual Disease Detection in Resectable Lung Cancer (2026 Edition). This consensus focuses on a systematic and in-depth discussion of key issues, including the selection of target populations for MRD detection, optimization of technical detection pathways, determination of perioperative and postoperative longitudinal follow-up time points, and the clinical value of MRD status in guiding escalation or de-escalation strategies for both treatment-naïve patients and those receiving neoadjuvant therapy. In addition, the consensus specifies the essential components for standardizing MRD detection reports. The aim is to provide an objective scientific basis and decision-making reference for thoracic surgeons and oncologists in clinical practice, thereby advancing the field of resectable lung cancer toward a new era of individualized precision management.

     

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