铜梁地区吸烟者低剂量CT筛查早期肺癌的应用价值研究

Application Value of Low-dose CT Screening for Early Lung Cancer in Smokers in Tongliang Area

目的探讨铜梁地区吸烟者采用低剂量CT在早期肺癌筛查中的应用价值。方法选取重庆市铜梁区人民医院2020年1—12月期间体检中心早期肺癌筛查人群共892例作为研究对象,所有研究对象均明确存在吸烟史,并均接受胸部低剂量螺旋CT检查。根据CT影像结果进行诊断并对筛查出肺部结节人数、个数及结节性质进行分析。结果本研究共纳入892例体检研究对象,共有215例检出≥1枚非钙化结节,共检出458枚非钙化结节,明确检出阳性结节68例(7.62%),共95枚(20.74%),检出半阳性结节147例(16.48%),共363枚(79.26%),其中评价为恶性结节共7例(0.78%),共16枚(3.49%)。阳性结节与半阳性结节在不同密度类型结节分布中比较,差异有统计学意义(P<0.05)。高度怀疑恶性结节的7例患者经组织病理学证实腺癌3例,鳞癌4例,病理分期中Ⅰ期结节共11枚,Ⅱ期4枚,Ⅲ期1枚。结论低剂量螺旋CT在早期肺癌筛查中具有重要的应用价值,在保证高质量影像结果的基础上进一步降低CT检查电离辐射损伤,且低剂量螺旋CT检查更为方便、快捷,影像特征与诊断结果表现更为直接,有助于推动全民肺癌防治意识的普及。

Objective To explore the application value of low-dose CT in early lung cancer screening for smokers in Tongliang area.Methods A total of 892 patients with early lung cancer screening in the physical examination center from January to December 2020 in Tongliang District People′s Hospital of Chongqing were selected as the research objects.All study subjects had a clear history of smoking and underwent lowdose chest CT examination.The diagnosis was made according to the CT image results,and the number,number and nature of pulmonary nodules screened were statistically analyzed.Results A total of 892 physical examination subjects were included in this study,a total of 215 cases were detected with≥1 non-calcified nodule,and a total of 458 non-calcified nodules were detected.Positive nodules were clearly detected in 68 cases(7.62%),with a total of 95(20.74%).147 cases(16.48%)of semi-positive nodules were detected,with a total of 363(79.26%),among which 7 cases(0.78%)and a total of 16(3.49%)were evaluated as malignant nodules.There was a statistically significant difference between positive nodules and semi-positive nodules in the distribution of nodules of different density types(P<0.05).Among the 7 patients with highly suspected malignant nodules,3 cases of adenocarcinoma and 4 cases of squamous cell carcinoma were confirmed by histopathology.In the pathological staging,there were 11 nodules in stageⅠ,4 in stageⅡ,and 1 in stageⅢ.Conclusion Low-dose helical CT has important application value in early lung cancer screening.On the basis of ensuring high-quality imaging results,the ionizing radiation damage of CT examination can be further reduced,and low-dose helical CT examination is more convenient and fast.Imaging features and diagnostic results are more direct,which is helpful to promote the popularization of lung cancer prevention and control awareness among the whole nation.