摘要
[目的]探讨低剂量螺旋CT（LDCT）对社区肺癌高危人群的筛查效果。[方法]在社区招募7496名肺癌高危人群进行LDCT筛查。肺癌高危人群定义为年龄40岁以上,并且具有下列任何一项者：20包年以上的吸烟史、肺癌家族史、肺部既往病史（慢性阻塞性肺病、肺结核）、职业接触史（石棉、氡、砷、铬、镍接触史）。以发现至少一个≥4 mm非钙化结节为LDCT筛查的阳性结果。[结果]7496名肺癌高危人群进行LDCT肺癌筛查,非钙化结节≥4 mm者共1057名（14.1%）。年龄≥55岁的高危人群结节阳性率显著高于年龄〈55岁者（14.9%vs9.7%;χ2=22.27,P〈0.001）。筛查出肺癌33例,占结节阳性者的3.1%,肺癌检出率为0.44%。共确诊21例非小细胞肺癌,其中0-Ⅰ期11例,早期诊断率为52.4%。[结论]LDCT肺癌筛查有助于提高肺癌的早期诊断率和非钙化结节的检出率,尤以55岁以上人群值得推广。
[Purpose] To explore the effect of low-dose computed tomography（LDCT） screening for lung cancer in a high risk group from local community. [Methods] The 7496 community residents with high risk for lung cancer were enrolled. The person with high risk of lung cancer was defined as someone with age≥40,at least having one of the four requirements：a smoking history of at least20 pack years,a family history of lung cancer,a history of lung disease,and a history of occupational hazardous exposure,such as asbestos,radon,arsenic,chromium,nickel. LDCT scans that revealed any non-calcified nodule measuring at least 4mm was classified as positive outcomes. [Results] A total of 7496 persons at high risk for lung cancer underwent screening,with a result of1057（14.1%） participants having at least one non-calcified nodule with a diameter ≥4 mm. The positive rate in subjects more than 55 years old were higher than that of those less than 55 years old（14.9% vs 9.7%; χ2=22.27,P〈0.001）. A total of 33 lung cancers were diagnosed after a positive LDCT test. The detection rate of lung cancer was 3.1% in the group with a positive LDCT test and0.44% in the whole risk group. A total of 21 non-small cell lung cancer cases,with 11 cases in stage 0 - Ⅰ,were conformed in the screening trial and the percentage of early lung cancer was52.4%. [Conclusions] The LDCT screening may be helpful for early detection for lung cancer and positive non-calcified nodules,especially in high risk group aged more than 55 years old.
出处
《中国肿瘤》
CAS
2015年第10期811-814,共4页
China Cancer
基金
上海市闵行区卫生与计划生育委员会科研项目(2014MW33)
