Lung cancer screening with low-dose computed tomography: Experiences from a tertiary hospital in Taiwan
Lung cancer screening with low-dose computed tomography: Experiences from a tertiary hospital in Taiwan
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DOI：
10.1016/j.jfma.2015.11.007
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发表时间：
2016-03-01
影响因子：
3.2
通讯作者：
Hsu, Wu-Huei
中科院分区：
文献类型：
--
作者：
Chen, Chih-Yu;Chen, Chia-Hung;Hsu, Wu-Huei
背景/目的：据报道，使用低剂量计算机断层扫描（CT）进行肺癌筛查可降低高危吸烟者的肺癌特异性死亡率。然而，尽管亚洲肺癌的特征不同，但关于这一特定人群的筛查数据很少。我们的目的是分析肺癌筛查与低剂量CT胸部X线摄影在台湾的性能，参考国际experience.Methods：在1年期间，从2012年1月至2012年12月，我们进行了一项回顾性的，单中心的人口为基础的肺癌筛查计划，在每年的体检设置。参与者是无症状的成年人，没有任何癌症病史。向所有人提供低剂量CT和胸部X线摄影。基线CT评估被定义为积极的，如果任何非钙化结节直径>= 4毫米，然后被归类为固体，纯磨玻璃或部分磨玻璃optic.Results：3339个人，我们检测到34个癌症，产生的整体癌症检出率为1.02%。年龄小于50岁、一级亲属有各种癌症阳性家族史的高危人群癌症检出率特别高，为6.2%（8/129）。腺癌占88%（30/34），其中99%为早期（包括原位癌和I期）。在间隔生长的结节中，癌症的概率显著更高（比值比257.89，p = 0.0002）。磨玻璃样结节和实性结节之间的癌症概率没有显著差异（比值比1.16，p = 0.72）。结论：低剂量CT对早期肺癌的检出率为61.76%（21/34）。进一步建立肺癌筛查的选择标准，特别是针对亚洲个体，是绝对必要的。版权所有（C）2015，台湾医学会.出版社：Elsevier Taiwan LLC
Background/Purpose: Lung cancer screening using low-dose computed tomography (CT) has been reported to reduce lung cancer-specific mortality for smokers at high risk. However, despite different characteristics of lung cancer in Asia, there are few data concerning this specific population for screening. We aim to analyze the performance of lung cancer screening with low-dose CT concurrent with chest radiography in Taiwan, with reference to international experience.Methods: During the 1-year period from January 2012 to December 2012, we conducted a retrospective, single-center population-based screening program for lung cancer in the setting of annual medical examinations. Participants were asymptomatic adults without prior history of any cancer. Low-dose CT and chest radiography were offered to all individuals. Baseline CT evaluations were defined as positive if any noncalcified nodule >= 4 mm in diameter, which were then classified as solid, pure ground-glass or partial ground-glass opacity.Results: Of 3339 individuals, we detected 34 cancers, yielding an overall cancer detection rate of 1.02%. There was a particularly high cancer detection rate of 6.2% (8/129) in the high-risk group aged younger than 50 years with a positive family history of all types of cancers in first-degree relatives. Adenocarcinomas accounted for 88% (30/34) of cancers and 99% of them were early-stage (including carcinoma in situ and Stage I). The probability of cancers was significant higher in nodules with interval growth (odds ratio 257.89, p = 0.0002). There was no significant difference in the probability of cancers between ground glass opacity nodules and solid nodules (odds ratio 1.16, p = 0.72). Of all screen-detected cancers, 61.76% (21/34) were chest radiographically occult.Conclusion: Low-dose CT is effective to detect early lung cancers. Further establishment of selection criteria for lung cancer screening, specifically for Asian individuals, is definitely warranted. Copyright (C) 2015, Formosan Medical Association. Published by Elsevier Taiwan LLC.