单体检中心23695例体检者首次胸部低剂量CT筛查结果及肺结节相关易感因素的研究

目的 通过对体检者胸部低剂量CT（low-dose computed tomography，LDCT）筛查的结果及肺结节的相关易感因素进行分析，为早期肺癌筛查提供科学依据。方法 回顾性搜集体检中心23 695例体检者首次进行LDCT筛查的资料，对疑似肺癌的随访结果以及相关年龄、性别、生活史、既往史、家族史及部分检查状况进行整理统计。结果 本次筛查肺结节检出率79.79%，其中实性结节为71.43%，亚实性结节为22.98%；其他方面以心血管和肝脏疾病的检出率较高，分别为21.42%和24.49%。另外，疑似肺癌病例315例，随访确诊肺癌84例，其中Ⅰ期占比最高（69.05%，58例）、其次是Ⅱ期（20.24%，17例），早期诊断率为89.29%。肺结节的恶性病变检出率为0.44%，肺癌检出率为0.35%。其中部分实性结节的恶性病变率及确诊肺癌检出率较实性结节偏高。性别、年龄、吸烟、高血压病史是肺结节发生的独立易感因素（OR=0.969、0.790、0.922、0.863，均P<0.05）。结论 LDCT适合对人群进行大规模肺癌筛查，有助于及早发现肺内及其他部位可疑病变。在临床筛查过程中，更应重视对男性、年龄≥ 55岁、有吸烟史及高血压史等易感人群的肺癌筛查。

A study on the first chest low-dose CT screening and susceptible factors of pulmonary nodules in 23 695 physical examinees in a medical examination center

Objective To provide scientific basis for early lung cancer screening by analyzing the results of low-dose computed tomography (LDCT) screening and related susceptible factors of pulmonary nodules in physical examinees. Methods We retrospectively analyzed data from 23 695 cases in chest LDCT screening for the first time in our medical examination center.Information on follow-up of suspected lung cancer and the relevant age,gender,life history,past history,family history and some examination status were collected and analyzed. Results The detection rate of pulmonary nodules in this screening was 79.79%,including solid nodules (71.43%) and sub-solid nodules (22.98%).In other aspects,the detection rates of cardiovascular and liver diseases were relatively high (21.42% and 24.49%,respectively).In addition,315 cases of suspected lung cancer and 84 cases of lung cancer were confirmed by follow-up.Among them,stage Ⅰ accounted for the highest proportion (69.05%,58 cases),followed by stage Ⅱ (20.24%,17 cases),and the early diagnosis rate was 89.29%.The malignant rate of lung nodules was 0.44%, and the detection rate of lung cancer was 0.35%.Among them,the detection rates of malignant lesions and lung cancer inpartial-solid nodules were higher than those in solid nodules.Gender,age,smoking and history of hypertension were independent susceptibility factors for pulmonary nodules (OR=0.969,0.790,0.922,0.863,respectively,all P<0.05). Conclusion LDCT was suitable for large-scale lung cancer screening in people,which was helpful for early detection of suspicious lesions in the lung and other parts. In the clinical screening process,more attention should be paid to lung cancer screening for people with lung nodules susceptible to men,age ≥ 55 years old,with smoking and hypertension history.