【摘要】 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。更多还原

【Abstract】 Objective To evaluate the possibility and efficiency of early lung cancer screening using low-dose spiral CT,and to investigate the effects of prognosis of lung cancer. Methods 3005 routine chests check-up were carried on the low-dose prospect research of the SHIMADZU 7800 TX spiral CT. According to the result by tracing and long-term CT follow-up based on the baseline screening, biopsy or surgical excisions were recommended in "malignant change" or enlarged nodules. Two doctors separately interpreted all the images blindly.Results 29.9 rate of nodules in all of cases were detected. Smoking group was 1.3 times incidence of non-smoking. A whole incidence of lung cancer was 1.2, including 2.9 in people at high risk of lung cancer and 0.9 in common people. The sensitivity and specificity of lung cancer screening using low-dose spiral CT were 82.9 and 88.8 respectively, and the diagnostic accuracy of lung cancer screening in diameter of nodules less than 10 mm was high than in ones more than 10 mm. Histologically, 33 non-small cell lung cancers (19 stageⅠ, 10 stageⅡand 4 stageⅢ), 2 small cell lung cancers and 1 scar carcinoma were proved based on baseline screening by biopsy or surgery. By the end of 2007, the average survival for clinical stageⅠlung cancer was more than 4 years, clinical stageⅡwas 2～3 years and clinical stageⅢ was 1～2 years. Conclusion Low-dose spiral CT is of high sensitive and specificity in detecting early lung cancer. Preliminary screening study indicates that low-dose spiral CT can greatly improve the likelihood of detection for early lung cancer and situation of survival.更多还原