郑州市肺癌早期筛查检出肺结节临床特征及影响因素分析  

Clinical characteristics and influencing factors of pulmonary nodules detected in early screening of lung cancer in Zhengzhou

作　　者：王伟红 曹旸[2] 王晓翠 李培培 许迎喜 师卫翔 孟可 杨宇飞[4] 乔炳礼[2] 兑伟华 李蕾[2] 张培利[5] 马展 WANG Wei-hong;CAO Yang;WANG Xiao-cui;LI Pei-pei;XU Ying-xi;SHI Wei-xiang;MENG Ke;YANG Yu-fei;QIAO Bing-li;DUI Wei-hua;LI Lei;ZHANG Pei-li;MA Zhan(Zhengzhou Third People’s Hospital/Zhengzhou Cancer Hospital/Henan University Cancer Hospital/Zhengzhou Cancer Diagnosis and Treatment Quality Control Center/Zhengzhou Cancer Prevention and Treatment Office/Zhengzhou Cancer Center,Zhengzhou 450000,China;Department of Disease Control Zhengzhou Health Commission,Zhengzhou 450000,China;Department of Oncology,Xiyuan Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100091,China)

机构地区：[1]郑州市第三人民医院科教科/郑州市肿瘤医院/河南大学肿瘤医院/郑州市肿瘤诊疗质量控制中心/郑州市肿瘤防治办公室/郑州市癌症中心,河南郑州450000 [2]郑州市第三人民医院肿瘤科/郑州市肿瘤医院/河南大学肿瘤医院/郑州市肿瘤诊疗质量控制中心/郑州市肿瘤防治办公室/郑州市癌症中心,河南郑州450000 [3]郑州市卫生健康委员会疾控处,河南郑州450000 [4]中国中医科学院西苑医院肿瘤内科,北京100091 [5]郑州市第三人民医院肿瘤专科联盟/郑州市肿瘤医院/河南大学肿瘤医院/郑州市肿瘤诊疗质量控制中心/郑州市肿瘤防治办公室/郑州市癌症中心,河南郑州450000

出　　处：《中华肿瘤防治杂志》2022年第7期468-474,共7页Chinese Journal of Cancer Prevention and Treatment

基　　金：郑州区域肺癌早期筛查及干预技术的推广应用(2021KKJHM0010)。

摘　　要：目的分析郑州市肺癌早期筛查复筛检出情况,探讨肺癌早期筛查中肺结节临床特征及影响因素。方法收集2020-07-01-2020-12-30参加郑州市肺癌早期筛查的5000名40~75岁高危人群一般资料[包含年龄、性别、身体质量指数(BMI)、吸烟史、饮酒史、既往肿瘤史和癌症家族史等]和临床资料[包含低剂量螺旋CT(LDCT)等]。普查人群的特征按分类资料描述,χ^(2)检验或Fisher确切概率法检验肺结节的阳性检出率差异。对与肺结节有关联的因素采用二分类Logistic回归分析。结果5000名行LDCT肺癌筛查的肺癌高危人群中,非钙化肺结节≥5 mm 916例。其中肺结节阳性男676例(73.80%),女240例(26.20%)。单因素分析显示,年龄、BMI、婚姻状况、居住位置、取暖方式、使用燃料类别、体育锻炼和饮酒等因素均与肺结节相关,差异有统计学意义,均P<0.05。多因素二分类Logistic回归结果显示,居住位置,近3年长期处于精神压抑状况,BMI,每年持续>3个月咳嗽、咳痰及胸闷,长期应用激素等指标是影响检出肺结节阳性的独立危险因素。居住位置为城市(OR=2.271,95%CI:1.88~2.74)和城郊(OR=2.252,95%CI:1.76~2.88),每年持续>3个月咳嗽、咳痰及胸闷(OR=3.036,95%CI:2.61~3.54),近3年长期处于精神压抑状况(OR=1.711,95%CI:1.35~2.17)及长期应用激素(OR=2.132,95%CI:1.47~3.08)人群更容易检出肺结节阳性。结论居住在城市城郊,近3年精神处于压抑状况,BMI超重肥胖,每年持续>3个月咳嗽、咳痰及胸闷,长期应用激素状况等指标是检出肺结节阳性的独立危险因素,应重点关注。Objective To analyze the re-screening detection of early lung cancer screening in Zhengzhou,and to explore the cancer clinical characteristics and influencing factors of pulmonary nodules in early screening of lung tomography(LDCT).Methods The general data,including age,sex,body mass index(BMI),smoking history,drinking history,past tumor history and cancer family history and clinical data such as LDCT of 5000 people aged 40-75 who participated in early lung cancer screening in Zhengzhou from July 1,2020 to December 30,2020 were collected.The characteristics of the census population were described according to the classified data,χ^(2) test or Fisher exact probability method were used to test the positive detection rate of pulmonary nodules and the difference of detection rate among expression factors.The factors associated with pulmonary nodules were analyzed by binary logistic regression.Results Among the 5000 high-risk people of lung cancer screened by LDCT,916 cases of non-calcified pulmonary nodules≥5 mm were detected.Among them,676 cases(73.80%)were positive for pulmonary nodules in men and 240 cases(26.20%)in women.The univariate analysis showed that age,BMI,marital status,living location,heating mode,fuel type,physical exercise and alcohol consumption were all associated with pulmonary nodules,and the difference was statistically significant(P<0.05).The results of multivariate binary logistic regression showed that residential location,long-term mental depression for recent 3 years,BMI,cough,expectoration and chest tightness lasting more than 3 months every year,and long-term use of hormones,which were independent risk factors affecting the positive detection of pulmonary nodules,all P<0.05.People who live in cities(OR=2.271,95%CI:1.88-2.74)and suburbs(OR=2.252,95%CI:1.76-2.88),present with cough,expectoration and chest tightness for more than 3 months every year(OR=3.036,95%CI:2.61-3.54),have been in mental depression for a long time in recent 3 years(OR=1.711,95%CI:1.35-2.17)and have long-term hormone

关 键 词：肺癌早期筛查 低剂量螺旋CT 肺结节阳性 居住位置 危险因素 

分 类 号：R734.2[医药卫生—肿瘤]