肺癌CT普查:基础扫描与7年随访

目的　探讨肺癌CT普查对肺癌诊断分期和预后的影响。方法　前瞻性观察肺癌CT普查中不同年龄、性别、吸烟组肺癌发生率及分期 ,追踪预后和长期CT随访对非钙化性结节进一步定性的价值。结果　 2 43 0人共 10 0 2 0人次参加了肺癌CT普查 ,1994年至 2 0 0 1年共发现肺癌 2 5例 ;I期肺癌 12例 ,II期肺癌 6例 ,III期肺癌 7例 ;首次CT普查发现肺钙化结节 89例 ,其中首次诊断为肺癌的 19例 ,1～ 2年增大 ,证实为肺癌 4例 ;1995年至 1999年未参加普查 ,而 2 0 0 0年再普查发现新生肺癌 1例 ;1994年发现结节 ,2 0 0 1年才确诊 1例 ;新生结核肉芽肿 3例 ,隐球菌肉芽肿 1例 ;结核瘤再活动增大 2例。长期稳定 60例。结论　①肺癌CT普查能及时发现并诊断早期肺癌 ,主要在 5 0～ 69岁年龄组。②肺癌CT普查会发现大量非钙化结节 ,大部分为良性 ,需要配合HRCT、局部SpiralCT、活检、CT复查仔细鉴别 ,提高诊断水平。

CT Screening for Lung Cancer: Baseline and 7 Years Follow-up

Purpose To evaluate the effects of lung cancer CT screening on detection, staging and prognosis of lung cancer. Methods Observe the lung cancer frequencies and staging in different groups such as age, sex, smoking. Compare the prognosis and evaluate the meaning of long term CT follow up. Results With 2430 persons in baseline lung cancer CT screening and 10020 person time in repeat CT screening every 2 years, 25 cases of lung cancer were found from 1994 to 2001. Eighty nine cases of non calcified nodules were found. Ninety cases were diagnosed as lung cancer at the first CT screening, 4 cases showed growth after 1-2 year CT follow up confirmed to be lung cancer. One case was normal in 1994 CT screening, but stage II lung cancer in 2000 CT screening. One case of lung cancer was misdiagnosed in 1994 as benign nodule, operating in 2001 with same side lung metastasis. Newly seen nodule was confirmed to be tuberculosis in 3 cases, cryptococcus granuloma in 1 case on repeat CT screening. Another 2 cases with nodule growth were confirmed to be reactive tuberculoma. Sixty cases of nodules were stable for 6-7 years. Conclusion Lung cancer CT screening can find and diagnose early lung cancer timely and efficiently, mainly in age 50-69 group. The male and female, smoker and nonsmoker should be all enrolled in screening. Some amount of non calcific nodules were found, most of them were benign, international cooperation is needed for recognition of focal ground glass opacity lesions.