广州肺癌低剂量螺旋CT筛查经验

目的:总结评估广州市低剂量螺旋CT扫描肺癌筛查试验.方法:对广州呼吸疾病研究所2003年7月至2005年3月参加广州市肺癌筛查低剂量螺旋CT扫描试验的197人进行总结分析,并与国内外其它研究组进行比较分析.结果:197人选择单纯低剂量螺旋CT肺癌筛查,正常人群67例,占34%,高危人群130例,占66%;最终随访显示:未见异常92例,占46.7%,良性病变100例,占50.8%,确诊为肺癌5例,占2.5%,且5例肺癌均为非小细胞肺癌.低剂量螺旋CT肺癌筛查中肺癌小结节的发现率为5.08‰.其特异度是89.06%,敏感度是80%,准确度是88.83%.非高危人群的肺癌发病率为1.49%,高危人群的肺癌发病率为3.10%.非高危人群与高危人群的肺癌筛查结果分析差异有统计学意义(P＜0.01).本组肺癌筛查结果与ELCAP分析显示P＝0.0468,与国内外其它3组比较差异无统计学意义(P＞0.05).结论:低剂量螺旋CT扫描是目前相对更少侵袭、更少费用的肺癌筛查工具.

Low-dose Spiral CT Screening for Lung Cancer: Guangzhou Experience

Objective:To summarize on a clinical trial involving low-dose spiral CT screening for lung cancer in Guangzhou China.Methods:Between July 2002 and March 2005,197 subjects were screened with low-dose spiral CT for lung cancer.The results were analyzed and compared with other series from within and outside China.Results:Low-dose spiral CT was the only screening approach used in 197 subjects,which included 67 healthy participants(34%)and 130 high-risk individuals(66%).Overall,the follow-up revealed 92 subjects(46.7%)with negative findings,100(50.8%)with benign disorders,and 5(2.5%)with confirmed lung cancer(all of which were NSCLC).Low-dose spiral CT detected malignant pulmonary nodules in 0.508% of time,with 89.06% specificity,80% sensitivity and 88.83% accuracy.The rates of lung cancer in non high-risk and high-risk subjects were 1.49% and 3.10%,respectively(P<0.01).A P value of 0.0468 was shown when the results were compared with those of ELCAP study,however,no significant differences were found in comparison with other 3 series from within and outside China.Conclusion:So far,low-dose spiral CT provides a less invasive and less expensive tool for lung cancer screening.