徐伟凌?孟家晓

[摘要] 目的 探讨在早期肺癌中低剂量多层螺旋CT筛查的临床可行性，使早期肺癌的检出率有所提高。 方法 对佛山地区217名健康体检人员同时采用胸部X线和低剂量多层螺旋CT（MSCT）进行早期肺癌普查。低剂量多层螺旋CT所采用的仪器为Somatom Sensation 16 CT扫描机，扫描参数：120kV、20mAS、螺距为1.25、重建层厚为1mm、层间距为0.7mm，采用高分辨和标准重建算法。扫描时间为12～15s。比较两种方法早期肺癌筛查的阳性率。 结果 MSCT法共检测出39例结节性病变，其中23例非钙化结节，为早期肺癌（ⅠA期）的共5例，肺癌筛查阳性率为10.60%；胸片组共检测出9例结节性病变，其中3例非钙化结节，为肺癌（均为Ⅲ期）的共3例，肺癌筛查阳性率为1.38%。MSCT法的肺癌筛查阳性率明显高于胸部X线法，差异有统计学意义（P<0.05）。 结论 对于早期肺癌的筛查，低剂量多层螺旋CT法比胸片的筛查阳性率高，有利于提高早期肺癌的检出率，值得在临床中推广使用。

[关键词] 低剂量；多层螺旋CT；早期肺癌；筛查

[中图分类号] R142 [文献标识码] A [文章编号] 2095-0616（2017）16-251-03

Application of low dose lung MSCT in screening of early lung cancer among medical personnel in Foshan

XU Weiling MENG Jiaxiao

Department of Radiology，Foshan Fifth Peoples Hospital，Foshan 528211，China

[Abstract] Objective To explore the clinical feasibility of low dose multi slice spiral CT screening in early lung cancer，so as to improve the detection rate of early lung cancer. Methods 217 healthy people in Foshan were carried on early chest lung cancer screening and low-dose multi-slice spiral CT（MSCT） respectively.The instrument of low-dose multi-slice spiral CT was Somatom Sensation 16 CT scanner，scanning parameters：120kV，20mAS，pitch 1.25，reconstruction thickness was 1mm，the layer spacing was 0.7mm，with high resolution and standard reconstruction algorithm.The scan time was 12-15s.The positive rates of early lung cancer screening were compared between the two methods. Results MSCT were detected in 39 cases of nodular lesions，including 23 cases of non calcified nodules for early lung cancer （type A） a total of 5 cases，the positive rate of lung cancer screening was 10.60%.In the chest X-ray group，9 cases of nodular lesions were detected，of which 3 cases were non calcified nodules，and 3 cases of lung cancer （all stage Ⅲ），and the positive rate of lung cancer screening was 1.38%.The positive rate of lung cancer screening by MSCT was higher than that of chest X-ray，and the difference between the two was significant （P<0.05）. Conclusion For early lung cancer screening，low dose multi-slice spiral CT is more positive than chest X-ray screening，which is helpful to improve the detection rate of early lung cancer.It is worth popularizing in clinical practice.

[Key words] Low dose；Multi-slice spiral CT；Early stage of lung cancer；Screening

肺癌是威胁人类生命和健康的最大恶性肿瘤之一，其具有最快的发病率和死亡率，虽然手术成功的几率很高，但5年的存活率仅有13.9%[1]。而其中早期肺癌难以发现，在手术切除时已经发现了转移和确诊时已经无法用手术进行治疗，已经成为肺癌无法治愈的主要原因[2]。其中男性肺癌的发

病率和死亡率均趋于所有恶性肿瘤第一的位置，女性居于第二位[3]。在我国以及美国，肺癌的死亡率已经远远超过乳腺癌、结肠癌、卵巢癌之和，且以稳居于恶性肿瘤死亡率之首，呈现出逐年上升的趋势[4-5]。因为在早期诊断中缺乏有效地方法，在诊断的一年内，将近有80%的患者死亡[6]。……