低剂量计算机断层成像在高危人群早期肺癌筛查中的价值研究

Application Value of Low-dose Computed Tomography for the Screening of Lung-cancer in High-risk Group

目的研究低剂量计算机断层成像(low-dose computed tomography,LDCT)在高危人群早期肺癌筛查中的价值,寻找可行的肺癌筛查方法。方法对2007年1～12月在四川大学华西医院体检中心参加团体健康体检的40岁以上体检者共1551例(男性1054例,女性497例)进行LDCT检查,根据高危因素分为高危组和非高危组并对检查发现的肺部病变及肺癌检出情况进行分析。结果 LDCT在40岁以上体检人群中肺部病变的检出率为54.41%(844/1551);结节病变检出率29.40%(456/1551)。LDCT在40岁以上体检人群、肺癌高危人群及高危吸烟人群中肺癌检出率分别为0.51%(8/1551)、1.21%(7/577)和2.01%(6/298),后两者分别与前者比较,差异有统计学意义(P<0.05)。LDCT在无危险因素人群肺癌检出率为0.10%(1/974),有一个危险因素的人群肺癌检出率为0.98%(5/506),有两个危险因素的人群肺癌检出率为2.86%(2/70),3组间差异有统计学意义(P<0.05)。结论 LDCT在降低辐射剂量的同时,能敏感地检出无症状的肺癌,可望成为我国肺癌筛查的方法之一。

Objective To analyze the value of low-dose computed tomography（LDCT） in early screening of lung cancer in high-risk group.Methods LDCT was performed in 1551 adults over 40-years old（male 1054,female 497） for the screening of lung cancer in Examination Center of West China Hospital,Sichuan University,and the subjects were divided into high-risk group and non-high-risk group according to risk factors of lung caner.The detection rates of lung lesion and lung cancer in these two groups were carefully analyzed.Results In the people over 40-years old,the detection rate of pulmonary lesions by LDCT was 54.41%（844/1551）,the detection rate of nodules was 29.4%（456/1551）.Detection rate of lung cancer was 0.51%（8/1551）,while it was 1.21%（7/577） in high-risk group,and 2.01%（6/298） in heavy smoker group.The difference of lung cancer detection rate was significant（P〈0.05）.When stratified with the number of risk factors,the detection rate of lung cancer by LDCT was 0.10%（1/974） in the subjects without any high-risk factors,0.98%（5/506） in the subjects with one high-risk factor and 2.86%（2/70） in the subjects with more high-risk factors,and the differences were stastatically significant（P〈0.05）.Conclusion LDCT can detect asymptomatic lung cancer sensitively with low radiation dose,which could be helpful for the screening of lung cancer.