低剂量螺旋CT对35686例健康体检者的肺癌筛查分析

Analysis of the result of lung cancer screening with low-dose spiral CT for 35 686 physical examinees

目的了解采用低剂量螺旋cT进行健康体检人群肺癌筛查的特点。方法对解放军总医院国际医学中心2009年10月-2013年6月、已排除既往有恶性肿瘤病史的35686例健康体检人员采用低剂量螺旋cT进行肺癌筛查，根据筛查结果，分别按性别、年龄段等进行分组，比较肺癌检出率、病理分型及临床分期。结果筛检并经病理确诊肺癌51例（1．429％o），其中男性27例、女性24例，腺癌、鳞癌、小细胞癌分别为36、11、4例，1、2、3、4期肺癌分别为31、0、4、16例。肺癌总检出率、腺癌构成比、腺癌检出率及1期肺癌检出率女性均高于男性，肺癌平均分期及鳞癌、小细胞癌构成比女性均低于男性。腺癌、鳞癌、各期肺癌及男女肺癌检出率随年龄增长均呈上升的趋势。结论采用低剂量螺旋cT进行肺癌筛查有助于肺癌的早期发现并提高肺癌检出率．在健康体检人群中应积极开展。

Objective To investigate the distribution characteristics of lung cancer in physical examinees who used low-dose spiral CT for lung cancer screening. Methods Lung cancer screening with low-dose spiral CT was carried out from October,2009 to June,2013 in our center for 35 686 physical examinees without malignant tumor disease history. According to the results of screening, the lung cancer detection rate, pathological type and clinical stage were compared among groups of individuals of different gender and age respectively. Results 51 lung cancer patients were diagnosed by the report of pathological examination;the total detection rate was 1.429%. The numbers were 27 and 24 in male and female, 36,11 and 4 in adenocarcinoma,squamous carcinoma and small cell carcinoma,and 31,0,4 and 16 in clinical stage 1,clinical stage 2,clinical stage 3 and clinical stage 4,respectively. The total and clinical stage 1 detection rate of lung cancer as well as the proportion and detection rate of adenocarcinoma were higher in female than in male, but the mean average level of clinical stage and the proportion of squamous carcinoma were higher in male. The detection rates of adenocarcinoma, squamous carcinoma, and lung cancer of all clinical stages for both male and female increased with age. Conclution Lung cancer screening with low-dose spiral CT that can improve detection rate is helpful for early detection of lung cancer, and it will positively be carried out for physical examinees.