摘要
目的:应用低剂量螺旋CT(LDCT)对肺癌高危人群进行早期筛查,为预防控制肺癌提供依据,探讨中国LDCT早期肺癌筛查指南的适用性。方法:回顾性分析2014年-2020年符合肺癌高危人群标准(2013NCCN指南)且参加LDCT筛查、每年定期随访的1016例受试者(具有完整数据)的基线筛查数据,统计肺癌发病率;并根据2018中国LDCT早期肺癌筛查指南的阳性结节定义(实性或部分实性非钙化结节≥5 mm或磨玻璃结节≥8 mm)统计结节阳性率。结果:基线筛查时1016例受试者中女性仅占5.3%;共发现肺癌7例(均为男性,其中4例为肺部肿块和晚期肺癌),肺癌发病率为0.7%(7/1016)。以年龄及结节大小进行结节数量分组统计,发现60~70岁年龄组结节数最多,直径4~5 mm和5~6 mm结节数最多。根据2018中国指南的阳性结节定义,结节阳性率为20.4%(206/1012,排除4例肺部肿块),而若以实性结节≥6 mm或磨玻璃结节≥8 mm为阳性标准,阳性率为15.2%(154/1012),两者之间差异有统计学意义。结论:仍需进行中国人群的大样本前瞻性研究,以进一步完善中国指南的纳入标准及阳性结节标准,提高对中国人群的适用性。
Objective:Applying early screening to high-risk populations of lung cancer using low-dose computed tomography(LDCT)in order to provide evidence for prevention and control of lung cancer and explore the applicability of Chinese LDCT early screening guidelines for lung cancer.Methods:Retrospective analysis of 1023 individuals recruited from 2014 to 2020 who participated in LDCT screening program and met the criteria of high-risk individual of lung cancer(2013 NCCN guidelines)in Longquan,Sichuan.All the 1016 individuals were followed up regularly each year,and had complete data of baseline LDCT screening and prevalence of lung cancer.Positive nodules(solid or partially solid non-calcified nodule≥5mm or ground-glass nodule≥8mm)screening rate was analyzed according to 2018 China LDCT early screening guidelines of lung cancer.Results:At baseline screening,the proportion of women was only 5.3%;7 cases of lung cancer were found(all were male patients,4 of which were pulmonary masses and advanced lung cancer),and the prevalence of lung cancer was 0.7%(7/1016).When the number of positive nodules was stratified by age and nodule size,the highest number of nodules was found in the 60~70 age group and the diameter within 4~5mm and 5~6mm group.The positive nodule rate was 20.4%(206/1012,4 lung masses were excluded)according to 2018 China LDCT early screening guidelines of lung cancer.When using another criteria of positive nodules(solid nodules≥6mm or ground glass nodules≥8mm),the positive rate was 15.2%(154/1012).The difference between the two positive rate was statistically significant.Conclusion:A large sample of prospective study in Chinese population is still needed in order to further improve the inclusion criteria and standards of positive nodule definition in Chinese guidelines as well as the applicability in China.
作者
孟瑞瑞
刘圆圆
青浩渺
乔良
许国辉
周鹏
MENG Rui-rui;LIU Yuan-yuan;QING Hao-miao(Department of Radiology,Sichuan Cancer Hospital&Institute,Sichuan Cancer Center,School of Medicine,University of Electronic Science and Technology,Chengdu 61004,China)
出处
《放射学实践》
CSCD
北大核心
2021年第1期71-75,共5页
Radiologic Practice
基金
四川省应用基础研究基金[基于机器学习的智能化早期肺癌筛查与预警方法研究(重点)]。
关键词
低剂量螺旋CT
肺癌
筛查
高危人群
Low-dose computed tomography
Lung cancer
Screening
High risk population
