低剂量螺旋CT在早期肺癌筛查中的应用价值
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摘要
目的:探讨低剂量螺旋CT在早期肺癌筛查中的应用价值。方法:选择2016年5月至2017年10月在南充市中心医院接受低剂量螺旋CT肺癌筛查的吸烟人群2 100例作为研究对象,记录所有人群的影像学特征资料与一般人口学资料。结果:CT筛查出345例为阳性结节,占比16. 4%,实性结节245例,非实性结节60例,部分实性结节40例。CT筛查出肺癌30例,占阳性结节的8. 7%;经病理证实有27例肺癌患者,非实性结节、部分实性结节中肺癌的比例高于实性结节,对比差异显著(P <0. 05);不同结节患者的直径对比无显著差异(P> 0. 05)。在27例肺癌患者中,CT表现为边缘毛糙20例,光整7例;形态不规则22例,规则5例;胸膜凹陷12例,支气管充气征6例,空泡1例;临床分型:周围型23例,中央型4例。结论:低剂量螺旋CT在早期肺癌筛查中的应用有很好的价值,有利于肺结节的检出,有利于预防早期肺癌的进展。
Objective: To explore the application values of low dose spiral CT in screening of early lung cancer.Methods: From May 2016 to October 2017,2 100 cases of smokers in Nanchong Central Hospital who received low-dose spiral CT lung cancer screening were selected as the subjects. The imaging features and general demographic data of all cases were recorded. Results: There were 345 cases were screened by CT as positive nodules that accouted 16. 4% that 245 cases with solid nodules,60 cases of non solid nodules and 40 cases of part solid nodules. CT screening for lung cancer were 30 cases that accounted 8. 7% in the positive nodules,the pathologically confirmed 27 cases of patients with lung cancer. The proportion of lung cancer in the non solid nodules,part solid nodules were higher than the solid nodules that compared were significantly differences( P < 0. 05). There were no significant difference between patients with different diameter of nodules( P > 0. 05). In the 27 cases of lung cancer patients,CT showed 20 cases of marginal spiculae,finishing of 7 cases,22 cases of irregular shape,5 cases of pleural indentation rules. In clinical classification,23 cases were peripheral type,4 cases of central type. Conclusion: The application of low dose spiral CT in early lung cancer screening has great values,which is beneficial to the detection of pulmonary nodules,and is beneficial to the prevention of the progress of early lung cancer.
Objective: To explore the application values of low dose spiral CT in screening of early lung cancer.Methods: From May 2016 to October 2017,2 100 cases of smokers in Nanchong Central Hospital who received low-dose spiral CT lung cancer screening were selected as the subjects. The imaging features and general demographic data of all cases were recorded. Results: There were 345 cases were screened by CT as positive nodules that accouted 16. 4% that 245 cases with solid nodules,60 cases of non solid nodules and 40 cases of part solid nodules. CT screening for lung cancer were 30 cases that accounted 8. 7% in the positive nodules,the pathologically confirmed 27 cases of patients with lung cancer. The proportion of lung cancer in the non solid nodules,part solid nodules were higher than the solid nodules that compared were significantly differences( P < 0. 05). There were no significant difference between patients with different diameter of nodules( P > 0. 05). In the 27 cases of lung cancer patients,CT showed 20 cases of marginal spiculae,finishing of 7 cases,22 cases of irregular shape,5 cases of pleural indentation rules. In clinical classification,23 cases were peripheral type,4 cases of central type. Conclusion: The application of low dose spiral CT in early lung cancer screening has great values,which is beneficial to the detection of pulmonary nodules,and is beneficial to the prevention of the progress of early lung cancer.
引文
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[17]Zhang SF,Lu ZH,Chen MX. The application value of low dose spiral CT scan in lung cancer screening[J]. Chinese Journal of Practical Medicine,2017,44(1):105-107.[张淑芳,卢振辉,陈美笑.螺旋CT低剂量扫描在肺癌筛查中的应用价值[J].中国实用医刊,2017,44(1):105-107.]
[18]Talwar A,Rahman NM,Kadir T,et al. A retrospective validation study of three models to estimate the probability of malignancy in patients with small pulmonary nodules from a tertiary oncology follow-up centre[J]. Clin Radiol,2017,72(2):172-177.
[19]Leutz-Schmidt P,Weinheimer O,Jobst BJ,et al. Influence of exposure parameters and iterative reconstruction on automatic airway segmentation and analysis on MDCT-An ex vivo phantom study[J]. PLo S One,2017,12(8):e0182268.
[20]Chen ZJ. The value of 16 row spiral CT low dose scanning technique in the diagnosis of pulmonary nodules[J]. Modern Medical Imagelogy,2017,26(4):1045-1047.[陈卓坚. 16排螺旋CT低剂量扫描技术在肺结节诊断中的价值研究[J].现代医用影像学,2017,26(4):1045-1047.]
[21]Liu TW,Hung YN,Soong TC,et al. Increasing receipt of hightech/High-cost imaging and its determinants in the last month of taiwanese patients with metastatic cancer,2001-2010:A retrospective cohort study[J]. Medicine(Baltimore),2015,94(32):1354-1355.
[22]VokóZ,Barra M,Molnár A,et al. Model concept of the health economic evaluation of low-dose CT lung cancer screening in Hungary[J]. Orv Hetil,2017,158(25):963-975.
[23]Zhang JY,Xing L,Fu PY,et al. The application of CT individualized low dose scan in general population chest examination[J].Shandong Medical Journal,2017,57(17):88-90.[张金英,邢璐,伏平友,等. CT个体化低剂量扫描在普通人群胸部体检中的应用[J].山东医药,2017,57(17):88-90.]
[24]Infante M,Sestini S,Galeone C,et al. Lung cancer screening with low-dose spiral computed tomography:evidence from a pooled analysis of two Italian randomized trials[J]. Eur J Cancer Prev,2017,26(4):324-329.
[2]Simmerman EL,Thomson NB,Dillard TA,et al. Free lung cancer screening trends toward a twofold increase in lung cancer prevalence in the underserved Southeastern United States[J]. South Med J,2017,110(3):188-194.
[3]Low DA,Yang L,Chen J,et al. Technical Note:Analysis of motion blurring artifact in fast helical free-breathing thoracic CT scans[J]. Med Phys,2017,44(4):1456-1461.
[4]Huang Z,Xu HR,Ding Y,et al. Occurrence of small pulmonary nodules in patients with non-malignant tumors:a preliminary single-center study[J]. Cancer Research and Clinic,2015,27(3):157-160.[黄真,徐海荣,丁易,等.非恶性肿瘤人群中肺小结节发生率的单中心初步研究[J].肿瘤研究与临床,2015,27(3):157-160.]
[5]Jing YJ. Treatment and progress of low dose spiral CT lung cancer screening and detection of pulmonary nodules[J]. Oncology Progress,2017,15(4):349-353.[金玉晶.低剂量螺旋CT肺癌筛查检出肺结节的处理及进展[J].癌症进展,2017,15(4):349-353.]
[6]Su ZJ. Digital radiography chest and low-dose spiral CT scanning applications for lung cancer screening[J]. Journal of Practical Medical Techniques,2017,24(8):825-828.[苏志钧.胸部数字化X线摄影与低剂量螺旋CT扫描在肺癌筛选中的应用价值[J].实用医技杂志,2017,24(8):825-828.]
[7]Hubers AJ,Heideman DA,Duin S,et al. DNA hypermethylation analysis in sputum of asymptomatic subjects at risk for lung cancer participating in the NELSON trial:argument for maximum screening interval of 2 years[J]. J Clin Pathol,2017,70(3):250-254.
[8]Liang MQ,Zhang J,Lin JT,et al. The application of low dose spiral CT scan in the screening of high risk population of lung cancer[J]. Modern Diagnosis&Treatment,2017,28(7):1312-1313.[梁敏群,张杰,林建团,等.胸部低剂量螺旋CT扫描在肺癌高危人群筛查中的应用[J].现代诊断与治疗,2017,28(7):1312-1313.]
[9]Zhang YP. The value of multi row spiral CT(low dose)screening and diagnosis of early lung cancer in high risk population[J]. Journal of Imaging Research and Medical Applications,2017,1(11):130-131.[张永萍.多排螺旋CT(低剂量)筛查及诊断高危人群早期肺癌价值分析[J].影像研究与医学应用,2017,1(11):130-131.]
[10]Zhu XQ. Clinical observation of 64 row spiral CT low dose scan and target scan in the diagnosis of early lung cancer in high risk population[J]. Journal of Imaging Research and Medical Applications,2017,1(11):141-142.[朱小青. 64排螺旋CT低剂量扫描并靶扫诊断高危人群早期肺癌的临床观察[J].影像研究与医学应用,2017,1(11):141-142.]
[11]Luo X,Zheng S,Liu Q,et al. Should nonsmokers be excluded from early lung cancer screening with low-dose spiral computed tomography community-based practice in Shanghai[J]. Transl Oncol,2017,10(4):485-490.
[12]Gao JW,Rizzo S,Ma LH,et al. Pulmonary ground-glass opacity:computed tomography features,histopathology and molecular pathology[J]. Transl Lung Cancer Res,2017,6(1):68-75.
[13]Guo JB,Li YL. Exploration of value of conventional dose and low dose CT scan in diagnosis of pulmonary nodule[J]. Chinese Journal of Modern Drug Application,2017,11(11):7-9.[郭剑波,李玉林.常规剂量与低剂量CT扫描诊断在肺结节中的价值探讨[J].中国现代药物应用,2017,11(11):7-9.]
[14]Paolini M,Wirth K,Tufman A,et al. Thoracic lymph node delineation at dose-reduced(1 m Sv)dose-modulated contrast enhanced MDCT:S retrospective pilot study[J]. Radiol Med,2016,121(8):644-651.
[15]Palma JF,Das P,Liesenfeld O. Lung cancer screening:utility of molecular applications in conjunction with low-dose computed tomography guidelines[J]. Expert Rev Mol Diagn,2016,16(4):435-447.
[16]Lu HL,Gu LS,Lu HZ,et al. Application of low-dose spiral CT to outpatient opportunistic screening for lung cancer[J]. China Cancer,2017,26(3):185-189.[罗海亮,顾禄寿,罗好曾,等.低剂量螺旋CT在肺癌门诊机会性筛查中的应用[J].中国肿瘤,2017,26(3):185-189.]
[17]Zhang SF,Lu ZH,Chen MX. The application value of low dose spiral CT scan in lung cancer screening[J]. Chinese Journal of Practical Medicine,2017,44(1):105-107.[张淑芳,卢振辉,陈美笑.螺旋CT低剂量扫描在肺癌筛查中的应用价值[J].中国实用医刊,2017,44(1):105-107.]
[18]Talwar A,Rahman NM,Kadir T,et al. A retrospective validation study of three models to estimate the probability of malignancy in patients with small pulmonary nodules from a tertiary oncology follow-up centre[J]. Clin Radiol,2017,72(2):172-177.
[19]Leutz-Schmidt P,Weinheimer O,Jobst BJ,et al. Influence of exposure parameters and iterative reconstruction on automatic airway segmentation and analysis on MDCT-An ex vivo phantom study[J]. PLo S One,2017,12(8):e0182268.
[20]Chen ZJ. The value of 16 row spiral CT low dose scanning technique in the diagnosis of pulmonary nodules[J]. Modern Medical Imagelogy,2017,26(4):1045-1047.[陈卓坚. 16排螺旋CT低剂量扫描技术在肺结节诊断中的价值研究[J].现代医用影像学,2017,26(4):1045-1047.]
[21]Liu TW,Hung YN,Soong TC,et al. Increasing receipt of hightech/High-cost imaging and its determinants in the last month of taiwanese patients with metastatic cancer,2001-2010:A retrospective cohort study[J]. Medicine(Baltimore),2015,94(32):1354-1355.
[22]VokóZ,Barra M,Molnár A,et al. Model concept of the health economic evaluation of low-dose CT lung cancer screening in Hungary[J]. Orv Hetil,2017,158(25):963-975.
[23]Zhang JY,Xing L,Fu PY,et al. The application of CT individualized low dose scan in general population chest examination[J].Shandong Medical Journal,2017,57(17):88-90.[张金英,邢璐,伏平友,等. CT个体化低剂量扫描在普通人群胸部体检中的应用[J].山东医药,2017,57(17):88-90.]
[24]Infante M,Sestini S,Galeone C,et al. Lung cancer screening with low-dose spiral computed tomography:evidence from a pooled analysis of two Italian randomized trials[J]. Eur J Cancer Prev,2017,26(4):324-329.