数字胸片筛查肺癌的限度分析

Analysis on the limitation of digital chest radiograph in screening for lung cancer

目的分析数字胸片筛查肺癌的限度,评价其临床应用价值。方法选择肺癌高危人群(大于等于50岁,吸烟史大于等于20a)387例行数字胸片及低剂量多层螺旋CT(MSCT)全肺薄层扫描检查,分析数字胸片检出中央型和周围型肺癌的敏感性、特异性,并对数字胸片漏诊病例进行分析。结果数字胸片正确诊断2例周围型肺癌和1例中央型肺癌,敏感性分别为33.3%、20.0%,特异性分别为99.2%、99.2%;1例周围型肺癌和3例中央型肺癌未被检出;数字胸片对早期肺癌征象检出率低,有3例周围型肺癌被误认为良性病变。结论除结构重叠外,图像处理也影响数字胸片筛查肺癌的检出率,细致的图像后处理可以提高其应用价值。

Objective Analysing the limitation of digital chest radiograph in screening for lung cancer, and evaluating it＇s clinical application. Methods 387 smokers（ ≥ 50 years old, with more than 20 pack per years cigarette smoking）underwent digital chest radiograph and low-dose thin-section multi-slice CT（MSCT）; Analysing the sensitivity and specificity of digital chest radiograph in detecting central and peripheral lung cancer, and analyzing the eases which were missed at digital chest radiograph. Results 2 eases of peripheral lung cancer and 1 eases of central lung cancer were defined by chest radiography, the sensitivity is 33.3 %, 20.0 % and specificity is 99. 2 %, 99. 2 % respectively; 3 cases of central lung cancer and 1 eases of peripheral lung cancer were missed which were subterraneous or at early stage. Digital chest radiograph can＇t display the signs of early lung cancer accurately, and 3eases of early lung cancer were mistaken as benign disease. Conclusion The value of digital chest radiograph is not only effeeted by overlapped structure but also image processing in screening for lung cancer, processing image carefully can improve it＇s usefulness.