健康体检人群恶性肿瘤的检出特点

Characteristics of neoplasma in 140 127 adults undergoing health check-up

目的回顾性分析健康体检人群中恶性肿瘤的检出特点，探讨如何提高健康体检人群中的恶性肿瘤检出率。方法以我院近5年健康体检人群140127例中发现并病理确诊的186例恶性肿瘤患者为研究对象。比较恶性肿瘤的检出与年龄、性别、地域等关系以及症状和实验室阳性结果对恶性肿瘤诊断的作用。结果病理确诊恶性肿瘤的检出率为0．133％（186例）。前5位恶性肿瘤依次为肺癌0．036％（51例）、肝癌0．017％（24例）、肾癌0．014％（20例）、结直肠癌0．013％（18例）和胃癌0．011％（16例）。186例恶性肿瘤中无症状者158例，占84．9％。超声对肝、肾、甲状腺癌等实质性脏器的灵敏度优于肿瘤标志物（TM）；将胸片、TM、症状和胸部低剂量CT相结合，可提高肺癌检出率。2008年消化道恶性肿瘤检出率高达0．083％，明显高于其他年度（χ2=11．792，P〈0．05）及当年度肺癌检出率（χ2=8．538，P〈0．05）。结论健康体检是早期发现恶性肿瘤的重要途径。由于体检发现的恶性肿瘤大部分无症状，而超声、胸片、TM和CT对恶性肿瘤的检出作用各有特点，充分发挥总检医生和检后随访的作用，将有助于提高恶性肿瘤的检出率。

Objective Retrospectively investigate the characteristics of neoplasma of health check- up participants to find ways to improve cancer detection rate. Methods A total of 186 confirmed cancer patients were enrolled in this study. Personal information, including age, gender, and location were collected. The contribution of clinical symptoms, physical examination and laboratory test to cancer detection was investigated. Results Biopsy confirmed cancers accounted for 0. 133% （ 186/140 127 ） . Lung （ 0. 036% ） , liver （ 0.017 % ） , kidney （ 0. 014% ） , colorectal （ 0. 013 % ） and gastric cancer （ 0. 011% ） were the most commonly found neoplasma. Detection rate of liver cancer in male was significantly higher than that in female （χ2 = 6. 181, P 〈 0. 05 ）. Asymptomatic cancer was found in 158 adults （ 84. 9% ）. Ultrasound showed a significantly higher sensitivity to liver, kidney and thyroid cancer than tumor biomarkers. The detection of lung cancer was improved with the combination of X ray, tumor marker （TM）, clinical symptom and low-dose chest CT scan. In 2008, the detection rate for digest system carcinoma （0. 083% ） and lung cancer （ χ2 = 8. 538, P 〈 0. 05 ） was significantly increased （χ2 = 11. 792, P 〈 0. 05 ）. Conclusions Health check-up plays an important role in early detection of cancer. The combined use of physical examination, chest X ray, ultrasound test,TM and CT may improve the detection of cancer.