天津地区低剂量CT肺癌基线筛查与随访的初步临床分析

摘要

Objective:To explore the efficacy of low-dose computed tomography (LDCT) baseline and follow-up scans of lung cancer screening and to analyze lung nodules and other thoracic lesions detected from baseline and follow-up. Methods:A total of 650 sub-jects were enrolled in the LDCT lung cancer screening program, and investigators mainly focused on the analysis of 548 subjects who participated in the follow-up scan. The investigators recorded the nodules and other lesions of baseline screening, compared them with the follow-up images, and recorded their progress. Results:A total of 101 subjects were positive in the baseline screening, with a positivity rate of 18.4%. Six cases of lung cancer were confirmed by pathology, with a detection rate of 0.92%(6/650). The detection rate of lung cancer in female non-smokers (1.59%) was higher than that in male smokers (1.04%) without significant difference (P=0.624). Detected in the follow-up scan were 19 cases of new nodule-positive subjects. The positive rate for new nodules was 3.5%(19/548). The difference between the three-and two-dimensional levels was statistically significant. Conclusion:The effect of LDCT screen-ing for early lung cancer is significant. The detection rate in female non-smokers was not significantly higher than that in male smok-ers. Thus, LDCT lung cancer screening is equally significant for both sexes. The computer-aided detection (CAD) volume measurement technique is better to evaluate the progress of nodules during the follow-up interval.%目的:探讨低剂量CT(low-dose computed tomography,LDCT)基线与随访扫描的筛查效果,并对基线检出与随访新发结节及其他胸部病变进行临床分析.方法:研究纳入2014年2月至2016年6月参与天津市肿瘤医院放射科肺癌筛查试验的650例被试者,并侧重对其中完成随访扫描的548例被试者进行分析.研究者记录基线筛查检出结节以及其他病变,将其与随访扫描的LDCT图像相比较,记录其进展情况.结果:LDCT基线筛查有101例被试者为阳性,阳性率为18.4%.共检出6例肺癌结节,肺癌检出率0.92%(6/650).女性非吸烟者的肺癌检出率1.59%(2/126)高于男性吸烟者1.04%(4/383),差异无统计学意义(P=0.624).随访扫描检出19例新发结节阳性被试者,新发结节阳性率为3.5%(19/548).以三维水平对结节增大或减小的判定比例均高于二维水平.结论:LDCT肺癌筛查对早期肺癌的筛查效能显著,对女性非吸烟者行LDCT肺癌筛查同样意义重大.计算机辅助诊断系统(CAD)三维容积测量技术,相较于二维直径的评估更能对随访间隔内结节的进展做出评价.