8777例航天从业人员肺部结节的筛查结果分析  

Analysis on results of pulmonary nodules screening in 8777 aerospace staffs

作　　者：张晗[1] 王郑芳[1] 李凤卫[2] 谢秋霞[1] 高淑婷[1] 陈应泰[2] 

机构地区：[1]北京航天总医院健康管理中心,北京市100076 [2]北京航天总医院胸外科,北京市100076

出　　处：《广西医学》2016年第10期1416-1418,1433,共4页Guangxi Medical Journal

基　　金：中国航天科技集团公司第一研究院2015年度创新基金项目(2015-401)

摘　　要：目的了解健康航天从业人员肺部结节的检出情况及其特点。方法接受低剂量螺旋CT肺部疾病筛查的航天从业人员8 777例,收集其临床及影像学资料,分析肺部结节的检测率及其与性别、年龄、从事工种的关系,总结接受手术治疗者病理特点等。结果肺部结节的总检出率为12.42%(1 090/8 777),男性及女性检出率比较,差异无统计学意义(P>0.05),但一线工作人员检出率高于后勤保障人员(分别为13.07%、10.67%,P<0.05)。随着年龄的增长,男性、女性的肺部结节检出率均呈上升趋势(P<0.05)。74例肺部结节患者接受手术治疗,术后病理证实良性病变13例(17.57%),非典型腺瘤样增生19例(25.68%),原位腺癌13例(17.57%),微浸润腺癌12例(16.22%),浸润性腺癌14例(18.92%),黑色素瘤、血管周细胞瘤和小细胞肺癌各1例(各1.35%)。检出肺结节的人群中,女性患者与肺部结节较大(直径≥8 mm)的患者接受手术治疗的比例比男性患者与肺部结节较小(直径<8 mm)的患者高(P<0.05)。结论航天从业人员中肺部非钙化结节的检出率较高,且一线工作人员的检出率要高于后勤保障人员,值得关注。在航天从业人员健康体检中普及推广低剂量螺旋CT筛查肺部结节对肺癌的早期诊治具有重要的临床价值。Objective To explore the incidence rate and characteristics of pulmonary nodules in the aerospace staffs. Methods A total of 8 777 aerospace staffs received screening for pulmonary disease by low-dose spiral CT. And their clinical and imaging data were collected. The detection rate and its relationship with gender,age and type of work were analyzed. The pathological features of the cases receiving surgical therapy were summarized. Results The total detection rate of pulmonary nodules was 12. 42%（ 1 090 /8 777）. There was no statistical difference in the detection rate between the male and the female（ P〉0. 05）,but the detection rate of frontline staffs was higher than that of support staffs（ 13. 07% vs. 10. 67%,P〈0. 05）. The detection rates of pulmonary nodules in the male and the female tended to increase with the increasing age（ P〈0. 05）. Seventy-four patients with pulmonary nodules received surgical treatment. The postoperative pathological results showed that benign lesions was found in 13 cases（ 17. 57%）,atypical adenomatous hyperplasia in 19cases（ 25. 68%）,adenocarcinoma in situ in 13 cases（ 17. 57%）,microinvasive adenocarcinoma in 12 cases（ 16. 22%）,invasive adenocarcinoma in 14 cases（ 18. 92%）,and melanin tumor,angiopericytoma and small cell lung cancer in 1 case separately（ 1. 35% separately）. Among the cases of pulmonary nodules,the proportions of cases receiving surgical therapy in the female and the patients with larger nodules（ diameter ≥8 mm）were higher than those in the male and the patients with smaller nodules（ diameter 8 mm）（ P〈0. 05）. Conclusion The detection rate of non-calcified pulmonary nodules is higher in aerospace staffs,and the rate of frontline staffs is higher than that of support staffs,which deserves more attention. For aerospace staffs,the popularization of screening for pulmonary nodules using low-dose spiral CT in physical examination has clinical value for early diagnosis and treatment of lung cancer.

关 键 词：肺部结节 肺癌 筛查 低剂量螺旋CT 诊断 治疗 

分 类 号：R734.2[医药卫生—肿瘤]