探讨胸部低剂量CT在老年体检人群肺癌早期筛查中的应用价值

To Investigate the Application Value of Chest Low-dose CT in the Early Screening of Lung Cancer in the Elderly Population

目的探究胸部低剂量CT在老年体检人群肺癌早期筛查中的应用价值。方法回顾性分析本院自2020年2月至2022年4月收治的248例老年肺癌患者的临床资料,全部患者均接受了胸部低剂量CT诊断,该组患者在实施病理学诊断后按照病理类型分为肺腺癌(n=221)及肺鳞癌(n=27),对比不同病理类型下肺癌患者的螺旋CT征象。结果该组患者实施胸部低剂量CT检查所显示的异常病变征象如下:胸膜病变82例(33.06%)、肺门肿块45例(18.15%)、空洞和空腔病变42例(16.94%)、肺内多发性结节22例(8.87%)、弥漫性肺间质性病变35例(14.11%)、孤立结节肿块影12例(4.84%)、气管狭窄和梗阻10例(4.03%)。实施胸部低剂量CT检查时,肺腺癌与肺鳞癌相比,毛刺/棘突、胸膜凹陷征、血管连接征所占比例较高,差异有统计学意义(P<0.05)。肺腺癌与肺鳞癌相比,分叶征、空泡/空洞征所占比例比较,差异无统计学意义(P>0.05)。低剂量胸部CT与常规剂量胸部CT比较CTDI、DLP、ED较低,差异有统计学意义(P<0.05)。常规剂量胸部CT与低剂量胸部CT比较主动脉弓上缘分层、支气管分叉层面、膈顶上缘层面的噪声值较低,差异有统计学意义(P<0.05)。结论采用胸部低剂量CT应用在老年体检人群中进行肺癌早期筛查时具有较好的应用价值,同时可发现不同病理类型肺癌在征象上存在明显的差异性,为疾病的诊断及治疗提供可靠依据,同时胸部低剂量CT与常规剂量胸部CT比较的辐射剂量更低,安全性有保障。

Objective To explore the application value of chest low-dose CT in the early screening of lung cancer in the elderly population.Methods Clinical data of 248 elderly patients with lung cancer admitted to our hospital from February 2020 to April 2022 were retrospectively analyzed.All patients received chest low-dose CT diagnosis.After pathological diagnosis,the patients in this group were divided into lung adenocarcinoma(n=221)and lung squamous cell carcinoma(n=27)according to pathological types.The spiral CT signs of lung cancer patients with different pathological types were compared.Results In this group of patients,low-dose CT examination of the chest showed the following abnormal pathological signs:there were 82 cases(33.06%)of pleural lesions,45 cases(18.15%)of hilar mass,42 cases(16.94%)of cavity and cavity lesions,22 cases(8.87%)of multiple pulmonary nodules,35 cases(14.11%)of diffuse pulmonary interstitial lesions,12 cases(4.84%)of solitary nodules,10 cases of tracheal stenosis and obstruction(4.03%).The proportion of burr/spinous process,pleural depression,vascular junction signs in lung adenocarcinoma was higher than that in lung squamous cell carcinoma(P<0.05).There was no significant difference in the lobulation and vacuole/cavity signs between lung adenocarcinoma and lung squamous cell carcinoma(P>0.05).The CTDI,DLP and ED of low-dose chest CT were lower than those of conventional chest CT,and the difference was statistically significant(P<0.05).Compared with low-dose chest CT,the noise values of the predestined layer of the aortic arch,the bronchial bifurcation layer and the diaphragmatic top border layer were lower,and the difference was statistically significant(P<0.05).Conclusion The application of low-dose chest CT has good application value in the early screening of lung cancer in the elderly physical examination population,and it can be found that there are obvious differences in the signs of different pathological types of lung cancer,which provides a reliable basis for the diagnosis and treatment of the disease.Meanwhile,the radiation dose of low-dose chest CT is lower than that of conventional chest CT,and the safety is guaranteed.