湘潭市某单位员工肺结节筛检情况及影响因素研究

目的调查某单位员工肺结节筛检情况,并分析其影像学特征和危险因素。方法选取某单位2019年度在湘潭市中心医院健康管理中心进行健康体检的3045名在职员工作为研究对象,进行低剂量螺旋CT(LDCT)肺结节筛检和问卷调查,分析其肺结节的检出情况及危险因素。结果共有2311名员工完成了LDCT肺结节筛检和问卷调查,肺结节检出839例,检出率为36.3%。<40岁体检者中检出4类结节10例,检出率0.6%;≥40岁体检者中检出4类结节2例,检出率0.4%。不同年龄、偏好熏制腌制食品、偏好高油脂油炸食品、鸡蛋频率、蔬菜量、运动锻炼、接触电磁辐射、接触烹饪油烟的员工肺结节检出率差异有统计学意义(均P<0.01)。多因素Logistic回归分析结果显示:年龄≥40岁(OR=1.64)、偏好熏制腌制类(OR=1.38)及高油脂油炸食品(OR=1.69)、接触电磁辐射(OR=1.27)、接触烹饪油烟(OR=1.32)、不参加运动锻炼(OR=1.59)是肺结节的危险因素。结论建议增加40岁以下健康人群LDCT肺结节筛检。年龄、饮食偏好、运动锻炼、烹饪油烟和电磁辐射环境可能是肺结节的影响因素。

Screening of pulmonary nodules among employees of a unit in Xiangtan and its influencing factors

Objective To investigate the screening of pulmonary nodules among employees of a unit, and analyze the imaging features and risk factors. Methods Low-dose spiral computed tomography （LDCT） pulmonary nodules screening and questionnaire survey were conducted on 3 045 on-the-job employees of a unit who underwent physical examination in the health management center of Xiangtan Central Hospital in 2019, and the detection and risk factors of pulmonary nodules were analyzed. Results A total of 2 311 employees completed LDCT pulmonary nodule screening and questionnaire survey. Among them, 839 pulmonary nodules were detected, with a detection rate of 36.3%. Ten cases and 2 cases of type 4 nodules were detected in < 40 years old and ≥ 40 years old respectively, and the detection rates were 0.6% and 0.4% respectively. There were significant differences in the detection rate of pulmonary nodules among employees of different age, preference for smoked and pickled food, preference for high fat fried food, frequency of eating eggs, vegetable intake, exercise, exposure to electromagnetic radiation and exposure to cooking fume （all P < 0.01）. The multivariate Logistic regression analysis showed that age ≥ 40 years old （OR=1.64）, preference for smoked and pickled food （OR=1.38） and high fat fried food （OR=1.69）, exposure to electromagnetic radiation（OR=1.27） and cooking fume（OR=1.32）, and no exercise（OR=1.59） were risk factors of pulmonary nodule. Conclusion It is suggested to increase LDCT pulmonary nodule screening in healthy people under 40 years old. Age, dietary preference, exercise, cooking fume and electromagnetic radiation may be the influencing factors of pulmonary nodules.