低剂量螺旋CT在肺癌门诊机会性筛查中的应用

Application of Low-dose Spiral CT to Outpatient Opportunistic Screening for Lung Cancer

[目的]探讨低剂量螺旋CT在肺癌门诊机会性筛查中的应用价值。[方法]在甘肃省武威肿瘤医院2013年1月1日至12月31日门诊就诊的人群中进行肺癌筛查,按筛查流程进行癌症防治知识和肺癌危险因素流行病学调查,详细询问病史及体格检查。采用美国GE公司16排螺旋CT(GE Briyht speed 16 CT)进行胸部低剂量薄层扫描。发现肺部有良性、可疑结节者均行3~18个月的随访;恶性结节行定位穿刺,纤维支气管镜、胸腔镜检查,手术、淋巴结活检,最终确诊均以病理组织学为依据。[结果]低剂量螺旋CT检查3016人,检出肺癌病例90例,检出率为2.98%,50~80岁组占总检出人数的92.22%。低剂量螺旋CT诊断肺癌的敏感性为88.89%,特异性为90.76%。[结论]低剂量螺旋CT机会性筛查肺癌检出率较高,是肺癌筛查的有效手段。

[Purpose] To evaluate the application of low-dose spiral CT in outpatient opportunistic screening for lung cancer. [Methods] Total 3016 outpatients from January 1,2013 to December31,2013 were screened for lung cancer with low-dose spiral CT. According to the screening process,the person made epidemiology investigation for cancer prevention and treatment knowledge and lung cancer risk factors,then inquired thorough disease history and examined carefully,and underwent 16-slice spiral CT for low-dose scan. The patients with benign lung nodules or suspicious nodules were followed up for 3 ~18 months. The patients with malignant nodules received needle aspiration,fiberobronchoscopy,thoracoscopy or lymph node biopsy,and final diagnosis were based on pathological histology. [Results] Following low-dose spiral CT examination of 3016 patients,90 cases were diagnosed,lung cancer detection rate was 2.98%. The 92.22% patients were aged 50 to 80. The sensitivity and specificity of low-dose spiral CT examination for diagnosis of lung cancer was 88.89%,90.76% with pathological results as gold standard.[Conclusion] Low-dose spiral CT screening for lung cancer has a higher detection rate,which is an effective method for lung cancer screening,particularly for individuals aged 50.