论文部分内容阅读
目的探讨低剂量螺旋CT筛查早期肺癌的可行性和有效性,以及对肺癌预后的影响。方法采用SHIMADZU 7800TX单螺旋CT扫描机对3005例行胸部查体人员进行低剂量螺旋CT检查的前瞻性研究,按照筛查处理原则追踪和长期CT随诊基线筛查结果,对有恶性倾向者或随诊增大者及时进行穿刺活检或手术切除。所有图像由2位放射医师采用盲法观察。结果在全部查体人群中,结节检出率为29.9%。吸烟组发现病变是非吸烟组的1.3倍,肺癌总体发生率为1.2%,其中高危人群肺癌发生率2.9%,普通人群为0.9%。低剂量螺旋CT对肺癌筛检的敏感性和特异性分别为82.9%和88.8%,且>10mm结节肺癌的诊断效能大于<10mm结节。35例恶性结节中肺癌34例,瘢痕癌1例;Ⅰ期肺癌19例,Ⅱ期10例,Ⅲ期4例,小细胞未分化癌局限期2例。截至2007年底,Ⅰ期肺癌平均生存期>4年,Ⅱ期肺癌平均生存期2~3年,Ⅲ期肺癌平均生存期1~2年。结论低剂量螺旋CT对肺癌早期发现具有高敏感度和特异度,可明显提高肺癌的早期检出率,改善肺癌患者的生存状况。
Objective To investigate the feasibility and effectiveness of low-dose spiral CT in the screening of early lung cancer and its impact on the prognosis of lung cancer. Methods SHIMADZU 7800TX single-helical CT scanner was used to screen low-dose helical CT in 3005 patients undergoing chest examination. According to the principle of screening and long-term CT follow-up, the screening results of patients with malignant tendency or Follow-up increased puncture biopsy or surgical removal in time. All images were blinded by 2 radiologists. Results In all the physical examination population, the detection rate of nodules was 29.9%. Smoking group found 1.3 times more lesions than non-smoking group, the overall incidence of lung cancer was 1.2%, of which high-risk population incidence of lung cancer 2.9%, 0.9% of the general population. The sensitivity and specificity of low-dose spiral CT for lung cancer screening were 82.9% and 88.8% respectively, and the diagnostic efficacy of> 10mm nodular lung cancer was greater than <10mm nodules. There were 34 cases of lung cancer and 1 case of scar cancer in 35 cases of malignant nodules. There were 19 cases of stage Ⅰ lung cancer, 10 cases of stage Ⅱ, 4 cases of stage Ⅲ, and 2 cases of small cell undifferentiated carcinoma. By the end of 2007, the average survival time of stage I lung cancer was> 4 years, the average survival stage of stage II lung cancer was 2 ~ 3 years, and the average survival stage of stage III lung cancer was 1 ~ 2 years. Conclusion Low-dose spiral CT has high sensitivity and specificity for the early detection of lung cancer, which can significantly improve the early detection rate of lung cancer and improve the survival of patients with lung cancer.