职业高危人群肺癌病例胸部X线片和痰细胞学筛查结果分析  

Retrospective analysis of screening results of lung cancer cases among occupational population at high risk of lung cancer

作　　者：范亚光 姜勇[2] 常润生 姚树祥[4] 胡平 乔友林[2] 

机构地区：[1]中国医学科学院放射医学研究所,天津300192 [2]中国医学科学院肿瘤研究所,北京100021 [3]个旧市红河州第三人民医院,661000 [4]昆明医学院公共卫生学院,650031 [5]National Cancer Institute,NIH,USA

出　　处：《中国肺癌杂志》2007年第2期102-106,共5页Chinese Journal of Lung Cancer

基　　金：美国国立卫生院癌症研究所基金(NCI-263-MQ-511694)资助~~

摘　　要：背景与目的 肺癌已成为中国癌症死亡的首位死因，以人群为基础的肺癌筛查的效果评价目前仍存在争议。本研究的目的是分析胸部X线片和痰细胞学筛查在职业高危人群肺癌早期检出中的作用。方法 对1992～1999年云锡矿工肺癌筛查队列的筛查结果进行回顾性分析。结果 共有9317名矿工参加了筛查，进行了46779次胸部X线片检查，45672次痰细胞学检查，793名队列成员至少有一次阳性结果，历年的阳性率为1214．1／100000～3482．7／100000。随访至2001年底，共433例肺癌发病，其中371例获得细胞／病理学结果，以鳞癌居多（55.0％），其次为腺癌和小细胞癌，Ⅰ，Ⅱ期肺癌占24．0％。62．1％的肺癌患者至少有一次阳性结果，胸部X线片单独检出165例，痰细胞学单独检出56例，两种方法联合检出48例，胸部X线片检出的肺癌以鳞癌腺癌居多（64．2％），痰细胞学检出的绝大多数为鳞癌（75.0％），有阳性筛查结果历史的早期肺癌占早期肺癌的80．8％。结论 本研究表明每年一次的胸部X线片联合痰细胞学肺癌筛查对职业高危人群肺癌的早期检出具有一定意义，可为我国高危人群肺癌的筛查提供一定的借鉴依据。Background and objective Lung cancer has become the leading cause of the cancer death in China. Population-based lung cancer screening is still in controversy. The objective of this study is to analyze the effect of annual chest radiography and sputum cytological screening conducted in high lung cancer risk population who were exposed to work related carcinogens. Methods A retrospective analysis was conducted to evaluate the screening results of the lung cancer cases diagnosed from 1992 to 2001 in the miners of Yunnan tin mine. Results A total of 9317 miners had been screened annually from 1992 to 1999. A total of 46 779 chest radiography and 45 672 sputum cytological examinations had been conducted, and 793 cohort subjects had at least one positive result. The annual positive detection rate ranged from 1214.1/100 000 to 3482.7/100 000. By December 31, 2001, 433 lung cancer cases had been confirmed, 371 cases out of them had cytological/path- ological evidence, and 55.0% were squamous cell carcinoma followed by adenocarcinoma and small cell carcinoma. Stage Ⅰ or Ⅱ accounted for 24 %. 62.1% of the cases had at least one positive screening result, while 165 cases were detected by chest radiography alone, 56 were detected by sputum cytology, and 48 were detected by both screening modalities. 64. 2% of X-ray detected cases were squamous/adenous carcinomas and 75.0% of cytological detected cases were squamous carcinoma. 80.8% of early stage cases had at least one previous positive finding from screening. Conclusion Annual lung cancer screening with combination of chest radiography and sputum cytology play some extent role in early detection of lung cancer in high risk population. The results may provide some primary data for lung cancer screening in special population who are at high risk of lung cancer in China.

关 键 词：肺肿瘤 X线 胸部X线片 痰细胞学 筛查 

分 类 号：R734.2[医药卫生—肿瘤]