摘要
目的分析胸部直接数字化放射摄影(DR)在高危人群早期肺癌筛查中的价值。方法对2007年1—12月在四川大学华西医院健康体检中心参加团体体检的年龄≥40岁的体检者14 452例进行DR检查,根据有无高危因素分为高危组4 405例和非高危组10 047例,对检查发现的肺部病变及肺癌检出情况进行分析。结果 14 452例受检者3 014例胸部DR检出肺部病变。高危组与非高危组胸膜病变、纤维条索影、片状影、结节影检出率比较,差异均有统计学意义(χ2值分别为37.01,133.73,21.94和144.06,P<0.05)。胸部DR发现肺部结节986例,检出率为6.8%,其中单结节影758例,多结节影228例。高危组与非高危组单结节影和多结节影检出率比较,差异均有统计学意义(P<0.05)。758例单结节影中635例(83.8%)为良性结节,123例(16.2%)性质不明;228例多结节影中199例(87.3%)为良性结节,29例(12.7%)性质不明。123例性质不明单结节影中共检出肺癌13例(10.6%);29例性质不明多结节影中共检出肺癌3例(10.3%);202例片状影中检出肺癌8例(4.0%);35例纵隔病变中检出肺癌2例(5.7%)。26例肺癌,病理证实肺癌14例、临床诊断12例;原发肺癌25例,其中Ⅰ期24例(Ⅰa期22例,Ⅰb期2例)、Ⅳ期1例,肝癌肺转移1例。高危组与非高危组间、不同年龄组间、不同数量危险因素组间肺癌检出率比较,差异均有统计学意义(P<0.05)。结论胸部DR能敏感的发现肺部病变,检出无症状肺癌,且年龄越高、危险因素越多,肺癌检出率越高,可望成为我国肺癌筛查的方法之一。
Objective To analyze the value of digital radiography （DR） in early screening of lung cancer among high - risk groups. Methods DR was applied for 14 452 people over 40 years old in examination center of West China Hospital, Si- chuan University from January 2007 to December 2007. The people were divided into high - risk group 4 405 and non - high - risk group 10 047 according to risk factors. And the lung diseases and lung cancer detected by DR were carefully analyzed. Results 3 014 out of the 14 452 patients were found with lung diseases by DR. The detection rate of pleural disease, fibrosis, patchy foei and nodules between high - risk group and non - high - risk group showed statistically significant differences （χ2 = 37.01 , 133.73, 21.94 and 144. 06, P 〈 0. 05 ） . The detection rate of nodules was 6.8% （986/14 452）, including 758 single nodules and 228 multi - nodules. The detection rate of single nodules and multi - nodules between the two groups showed statistically sig- nificant differences （P 〈0. 05 ） . The detection rate of BSPN and unknown nodules were 83.8% （635/758） and 16. 2% （ 123/ 758） in single nodules, while the detection rate of BSPN and unknown nodules were 87.3% （199/228） and 12. 7% （29/228） in multi - nodules. The detection rate of lung cancer were 10. 6% （13/123） in unknown single nodules, 10. 3% （3/29） in unknown multi - nodules, 4.0% （8/202） in patchy loci, 5.7% （2/35） in mediastinal disease. 14 cases of lung eancers were confirmed by pathology and 12 cases were clinically diagnosed, with 24 cases of I period （22 cases of I a, 2 cases of I b） and 1 case of 1W period. The detection rate of lung cancer among high - risk group, non - high - risk group, different age group and different risk factors group all showed statistically significant differences （ P 〈 0. 05 ）. Conclusion Pulmonary lesions and asymptomatic lung cancer can be detected by DR sensitively. The more the risk factors are and the older the age are, the greater the detection rate will be. It may become one of the methods in lung cancer screening.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第12期1432-1435,共4页
Chinese General Practice
基金
成都市科技局"肺癌防治关键技术研究"(09YTYB925SF-031)
