揭阳市肺癌高危人群低剂量螺旋CT筛查结果分析

Data analysis of the low-dose spiral CT screening for the high-risk population of lung cancer in Jieyang city

目的探讨适用于揭阳市的肺癌高危人群低剂量螺旋CT筛查路径模式,向民众普及肺癌的预防及早期筛查知识。方法通过揭阳市人民医院微信公众号、揭阳电视台爱健康栏目、揭阳日报等向揭阳市民宣传肺癌高危人群的特征及低剂量CT筛查的获益从而招募筛查人群,开放体检中心绿色通道为筛查人群提供便利。根据《低剂量螺旋CT肺癌筛查专家共识》的高危人群特征招募筛查人群。采用我院的西门子超高速SOMATOM Definition双源CT进行薄层扫描。对筛查出的肺部结节人数、肺部结节个数、恶性结节比例及人群资料等进行统计分析,同时研究生殖因素是否影响女性肺癌患者的发病率。结果2017年7月至2018年6月期间,共招募肺癌高危人群3535例,其中男性2085例(58.98%),女性1450例(41.01%),共筛查出肺部结节人群631例,两个以上结节人群150例,高度怀疑恶性结节53例,20例取得病理诊断,19例为肺癌,1例为肺结核,男性与女性肺癌患者检出率差异无统计学意义(P=0.573),女性人群中无肺部结节组与确诊肺癌组的平均活产个数比较差异无统计学意义(P=0.97)。结论胸部低剂量螺旋CT是一种有效的早期肺癌筛查方法可考虑进一步地推广,在筛查过程中严格遵守筛查指南规范可以确切地避免过度诊断和过度治疗。本项目在一定程度上推动了民众肺癌防治意识的普及。

Objective To investigate the low-dose spiral CT screening route model for the high-risk population of lung cancer in Jieyang city,and to spread the knowledge of lung cancer prevention and early screening.Methods The feature of lung cancer high-risk population and the benefit of low dose CT screening were advertised to Jieyang citizens for recruiting volunteers through several public broadcast ways.The Low Dose Spiral CT Lung Cancer Screening Expert Consensus were applied for participants recruitment.Siemens SOMATOM Definition CT was used for screening.The population of pulmonary nodule,the amount of pulmonary nodules,the proportion of malignant nodule and clinical feature of high-risk groups were analyze.The influence of reproductive factors on the incidence of lung cancer in women were investigated.Results From Jun 2017 to July 2018,a total of 3535 peoples considered as high-risk of lung cancer were recruited.Among them,2085 cases were males(58.98%)and 1450 cases were females(41.01%).A total of 631 cases were diagnosed with pulmonary nodules,150 cases with two or more nodules,and 53 cases were with highly suspected malignant nodules.Pathological diagnosis was conducted in 20 cases,there were 19 cases of pulmonary malignant tumor and 1 case of pulmonary tuberculosis.There was no significant difference in the detection rate between male and female lung cancer patients(P=0.57).There was no significant difference in the average number of live births between the group without pulmonary nodules and the group with confirmed lung cancer in the female population(P=0.97).Conclusion Low-dose spiral CT is an effective method for early lung cancer screening,which can be further promoted.Strict adherence to the screening guidelines during the screening process can definitely avoid overdiagnosis and overtreatment.This project has promoted the popularization of lung cancer prevention awareness among the public to a certain extent.