双排螺旋CT低剂量扫描在肺癌高危人群中的筛查效果及价值研究  

Effect and value of low-dose scanning by double-helical CT for screening lung cancer in high risk population

作　　者：冯新[1] 陈启才[1] 于伟[1] 高健[1] 冯涛[2] Feng Xin;Chen Qicai;Yu Wei;Gao Jian;Feng Tao(Department of Health Care,Central Hospital of Shengli Oilfield,Dongying 257034,China;Department of Respiratory Medicine,Central Hospital of Shengli Oilfield,Dongying 257034,China)

机构地区：[1]东营胜利油田中心医院保健科,257034 [2]东营胜利油田中心医院呼吸内科,257034

出　　处：《国际医药卫生导报》2018年第8期1253-1257,共5页International Medicine and Health Guidance News

摘　　要：目的 探讨低剂量螺旋CT在肺癌高危人群中的筛查中的应用效果及价值。方法 选择2014年8月至2017年6月科室参加体检者1 983例，检查时患者先行DR正位肺片拍摄，对于疑似人群进行低剂量螺旋CT检查；将获得的图像采用CT、DR片进行观察，对于形成统一意见后计入结果；对于意见不一致者由第三位医师介入，遵循少数服从多数原则；对于确诊患者给予相应的方法治疗加强患者随访，分析低剂量螺旋CT在肺癌高危人群中的筛查效果及价值。结果 1 983例肺癌高危人群中89例最终经过手术病理检查得到确诊，确诊率为4.49%。低剂量螺旋CT检查出194枚结节，高于DR检查43枚，差异有统计学意义（P＜0.05）；低剂量螺旋CT检查高度怀疑恶性结节例数及肺癌确诊率，均高于DR检查，差异有统计学意义（P＜0.05）；低剂量螺旋CT最终确诊85例肺癌，男性发病率为56.47%，高于女性43.53%，差异有统计学意义（P＜0.05）；男性鳞癌、小细胞癌发生率，高于女性，差异有统计学意义（P＜0.05）；男性腺癌发生率，低于女性，差异有统计学意义（P＜0.05）；低剂量螺旋CT检查确诊肺癌患者I期52.94%，II期37.65%，而病灶直径中45.88%病灶直径＜5 mm，44.71%病灶直径在5～10 mm。结论 将低剂量螺旋CT用于肺癌高危人群筛查中效果理想，能帮助患者早期确诊，为临床治疗提供影像学依据，值得推广应用。Objective To investigate the effect and value of low-dose scanning by double-helical CT for screening lung cancer in high risk population.Methods 1 983 subjects taking physical examination at our hospital from August,2014 to June,2017 were selected.All the subjects underwent DR radiographs and the suspected subjects took low-dose scanning by spiral CT.The images were obtained by CT and DR radiography and observed.The results of one opinion were included.The results of different opinions were intervened by third physician and followed the majority principle of obedience.The diagnosed patients were correspondingly treated and followed up.The effect and value of low-dose scanning by double-helical CT for screening lung cancer in high risk population were analyzed.Results Among the 1 983 cases,89 cases were diagnosed with lung cancer by pathological examination and the diagnosis rate was 4.49%.Low-dose spiral CT detected 194 nodules,which was 43 higher than the DR(P<0.05).More case were suspected with malignant nodules and the lung cancer diagnosis rate was higher by low-dose spiral CT and than by DR test(P<0.05).85 cases were diagnosed with lung cancer by low-dose spiral CT;among the 85 cases,56.47%were male and 43.53%female,with a statistical difference(P<0.05).The incidences squamous cell carcinoma and small cell carcinoma were higher in male than in female(P<0.05).52.94%were diagnosed with stage I lung cancer and 37.65%stage II by low-dose spiral CT examination.45.88%lesions’diameters were less than 5 mm and 44.71%5-10 mm.Conclusion Low-dose scanning by doublehelical CT for screening lung cancer in high risk population is effective and is helpful for the early diagnosis and can provide imaging evidence for clinical treatment,so it is worth being generalized.

关 键 词：低剂量螺旋CT 肺癌高危人群 筛查 应用价值 远期生存 

分 类 号：R730.44[医药卫生—肿瘤] R734.2[医药卫生—临床医学]