X线胸片后CT联合血清肿瘤标志物测定用于人群肺癌筛查的可行性研究

Analysis of the feasibility of lung cancer screening of the crowd with the CT scan plus detectiong of tumor makers in serum after chest X-ray

目的探讨在一般人群中,利用X线胸片后CT联合血清肿瘤标志物检测进行肺癌早期筛查的可行性。方法对11105名入组者予X线胸片检查,每年1次连续3年,其中胸片异常者再予CT联合血清肿瘤标志物检测,将结果进行总结分析并与国内外其他研究进行比较分析。结果11105人共行31548次X线检查,发现异常435例,再予CT联合血清肿瘤标志物检测,最终随访显示:未见异常175例,良性疾病249例,肺癌11例。其中CT的肺癌发现率为2.3%,特异度为98.8%,灵敏度为90.1%,假阳性率1.4%。其中血清肿瘤标志物阳性65例,其在肺癌组的阳性率明显高于其他两组,与CT联合的假阳性率2.36‰,提高了筛查的特异性。结论X线胸片后CT联合血清肿瘤标志物检测是一种经济、敏感、安全可行的肺癌筛查方法。

Objective To determine the feasibility of lung cancer screening in the general population with the CT scan plus detection of tumor makers in serum after chest X-ray. Methods X-radiographic scanning was applied to the chosen group（all together 11105 individuals） once every three years. CT scan combined with detection of tumor makers in serum were offered to those who had abnormal appearances of chest X-ray. Comparison and analysis with other study results from both abroad and internal were made.Results Further CT scan plus detection of tumor ma- kers in serum were made upon 435 medical anomaly appearances from the 31548 X-radio graphics of the group. The final following-up showed 175 normal medical cases together with 249 benign cases and 11 lung cancers. The CT scan showed 2.3% in discovery rate and 98.8% in specificity, together with a 90.1% of sensitivity and 1.4% of faluso epositive apperances. There were 65 positive blood serum out-comes （obvious higher in lung cancer group than that in the other two groups） and 2.36%0 faluse positives combined with CT-scannings. The result showed a remarkable improvement in the screening of lung cancer. Conclusion The CT scan combined with detection of tumor makers in serum after chest X-ray is a beneficial, sensitive and safe method for lung cancer screening.