魏新萍+马学东+江威+杨素华

摘 要 目的：探讨对社区40岁及以上肺癌高危人群进行低剂量螺旋CT（LDCT）的筛查效果。方法：从本社区肺癌高危人群数据库中登记的898例肺癌高危人群进行LDCT筛查。以发现至少1个≥4 mm非钙化结节为LDCT筛查阳性结果。结果：检出阳性结节者共137名（15.3%），其中男性结节阳性检出率14.6%，女性检出率15.7%，差别无统计学意义（P>0.05）。各年龄段阳性结节检出率差异无统计学意义（P>0.05）。共筛查出肺癌3例，肺癌检出率为0.33%，占结节阳性者的2.2%。其中有1例是早期肺癌，肺癌早期诊断率33.33%，3例肺癌年龄都在60岁以上。结论：LDCT在肺癌高危人群筛查应用，有助于提高肺癌的早期诊断率和非钙化结节的检出率，60岁以上高危人群的肺癌筛查应该引起高度关注。

关键词 肺癌；高危人群；筛查；低剂量螺旋CT

中图分类号：R734.2 文献标志码：A 文章编号：1006-1533（2018）02-

Analysis of the results of low-dose spiral CT screening for lung cancer in high-risk population in a community

WEI Xinping1， MA Xuedong1， JIANG Wei1， YANG Suhua2（1.General Department of Gumei Community Health Service Center of Minhang District， Shanghai 201102， China；2.Pr eventive-Care Division of Gumei Community Health Service Center of Minhang District， Shanghai 201102， China）

ABSTRACT Objective： To investigate the effect of low-dose spiral computed tomography CT （LDCT） screening in highrisk population aged over 40 years old in the community. Methods： LDCT screening was performed in 898 high-risk individuals with lung cancer registered from the database of high risk population of lung cancer in this community. LDCT result that revealed at least one ≥4mm non-calcified nodule was classified as the positive outcome. Results： A total of 137（15.3%） positive nodules were detected， among them the positive rate of male nodules was 14.6%， and that of the female was 15.7% and the difference was not statistically significant（P>0.05）. Each age positive nodules detection rate had no significant difference（P>0.05）. A total of 3 cases of lung cancer were detected by screening， and the detection rate of lung cancer was 0.33%， accounting for 2.2% of the cases with positive nodules. Among them， 1 cases were early lung cancer， the early diagnosis rate of lung cancer was 33.33%， and 3 cases of lung cancer were all over 60 years old. Conclusion： The application of LDCT in screening high-risk population of lung cancer is helpful to improve the early diagnosis rate and the detection rate of non calcified nodules， and screening for lung cancer in high risk population over the age of 60 should be paid close attention to.

KEY WORDS lung cancer； high risk group； screening； low-dose computed tomography

肺癌是目前世界范围内发病率和死亡率最高的恶性肿瘤。肺癌占我国全部恶性肿瘤死亡的22.7%，其五年总体生存率仅有16%左右[1]。而早期肺癌的5年生存率可达67%以上[2-3]，由于早期肺癌无特异性症状，因症就诊时大部分患者往往已为晚期，因此早期诊断是改善预后最重要和最有效的途径。低剂量螺旋CT（low-dose CT，LDCT）具有灵敏度高以及放射劑量少的优点，已经被一些组织和机构推荐应用于高危人群的肺癌筛查[4]。本研究旨在评估在社区肺癌高危人群中进行LDCT肺癌筛查的效果。endprint

1 资料与方法

1.1 研究对象

参考美国国立综合癌症网发布的肺癌筛查指南和其他肺癌高危人群筛查研究[4……