某单位体检人群的低剂量螺旋CT肺癌筛查:基线筛查结果  

Lung cancer screening with low-dose spiral CT in a unit staff: Results of the baseline screening

作　　者：欧阳碧函[1] 郭嘉[1] 周薇[1] 谭英[1] 刘绍辉[1] 张学伟[1] OUYANG Bihan;GUO Jia;ZHOU Wei;TAN Ying;LIU Shaohui;ZHANG Xuewei(Department of Health Management,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院健康管理中心

出　　处：《中南大学学报（医学版）》2019年第11期1252-1257,共6页Journal of Central South University ：Medical Science

摘　　要：目的:分析某单位人群在健康体检中检出的肺部结节情况及影像学特征。方法:某单位2018年度体检中完成低剂量螺旋CT(low-dose spiral computed tomography,LDCT)检查的年龄≥45岁员工共1372例,收集其临床及影像学资料,分析肺部结节的检出率、影像学特点及术后病理情况。结果:某单位45岁以上人群肺结节的总检出率为30.39%(417/1372)。检出结节以单发(227例)、实性(343例)、直径<5 mm(261例)、肺-报告和数据系统(Lung-Reporting and Data System,Lung-RADS)2类结节(340例)为主,单发结节好发于右上肺(74例,32.60%)。肺结节检出率随年龄增长而缓慢递减(P<0.05),Lung-RADS 4类结节检出率随年龄增长而递增(P<0.05),而性别对肺结节检出率无明显影响(P>0.05)。与Lung-RADS 3类结节比较,Lung-RADS 4类结节中亚实性、形状不规则及具有分叶征比例升高,且结节内有血管穿入的居多(均P<0.05)。11例患者行手术治疗,其中女性10例。术后病理学证实肺腺癌9例(2.16%),其中女性8例,均为非吸烟者。结论:结节呈亚实性、形状不规则、具有分叶征,且有血管穿入提示结节恶性倾向。女性非吸烟者的早期肺癌筛查值得重视。Objective:To analyze the incidence and imaging characteristics of pulmonary nodules in a unit staff.Methods:Low-dose spiral CT(LDCT)scan were performed in 1372 staffs≥45 years old in a certain unit during the physical examination.The clinical and imaging data were collected to analyze the detection rate,imaging characteristics,and postoperative pathological conditions of pulmonary nodules.Results:The total detection rate for pulmonary nodules was 30.39%(417/1372).The detected nodules were mainly single(227 cases),solid(343 cases),<5 mm in diameter(261 cases),and Lung-Reporting and Data System(Lung-RADS)category 2 nodules(340 cases).The single nodules were mostly found in the right upper lung(74 cases,32.60%).The detection rate of pulmonary nodules tended to decrease but the detection rate of category 4 nodules increased with the increasing age(P<0.05),while the gender had no significant influence on the detection rate(P>0.05).Compared with the Lung-RADS category 3 nodules,the proportions of nodules in subsolid state,with irregular shape,lobulation sign,and vascular penetration in the Lung-RADS category 4 were increased(all P<0.05).Among them,11 patients received surgical therapy,including 10 women.Postoperative pathology confirmed lung adenocarcinoma in 9 patients(2.16%),including 8 women,all non-smokers.Conclusion:The nodules in subsolid state with vascular penetration,irregular shape and lobulation sign tend to be malignant.Lung cancer screening with low-dose spiral CT in female non-smokers should be emphasized.

关 键 词：肺结节 肺癌 筛查 低剂量螺旋CT 健康体检 

分 类 号：R73[医药卫生—肿瘤]