Lung cancer risk and cancer-specific mortality in subjects undergoing routine imaging test when stratified with and without identified lung nodule on imaging study
Lung cancer risk and cancer-specific mortality in subjects undergoing routine imaging test when stratified with and without identified lung nodule on imaging study
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DOI：
10.1007/s00330-015-3775-3
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发表时间：
2015-12-01
影响因子：
5.9
通讯作者：
Lumbreras, Blanca
中科院分区：
文献类型：
--
作者：
Gomez-Saez, Noemi;Hernandez-Aguado, Ildefonso;Lumbreras, Blanca
为了评估胸片和CT显示有和无孤立性肺结节（SPN）患者的肺癌风险和特定死亡率，本前瞻性研究包括16，078例35岁患者（其中893例胸片或CT显示有SPN）和15，185例无SPN患者。患者随访18个月或直到被诊断为肺癌。采用Poisson回归分析计算两组肺癌的危险度和死亡率，SPN患者X线片肺癌发生率为8.3%（95%CI 6.0-11.2），CT为12.4%（95%CI 9.3-15.9）。X线片显示慢性阻塞性肺疾病患者（比值比2.62; 95% CI 1.03，6.67）和CT显示吸烟习惯患者（比值比20.63; 95% CI 3.84，110.77）与肺癌发生概率较高相关。在CT和X线片上，大结节大小和毛刺状边缘与肺癌相关。SPN患者的肺癌特异性死亡率低于无SPN患者（1.73/1000人-年，95% CI 1.08-2.88 vs. 2.15/1000人-年，95% CI 1.25-3.96）。临床人群中SPN患者的肺癌风险高于筛选研究。此外，SPN患者的死亡率低于无SPN患者。常规X线检查发现SPN的肺癌风险为8%，常规胸部CT发现SPN的肺癌风险为12.4%。吸烟、COPD、SPN直径和边缘是恶性肿瘤的预测因子。常规检查发现SPN的肺癌风险似乎高于筛查。
To assess the risk of lung cancer and specific mortality rate in patients with and without solitary pulmonary nodules (SPN) on chest radiograph and CT.This prospective study included 16,078 patients a parts per thousand yen35 years old (893 of them had an SPN detected with either chest radiograph or CT) and 15,185 without SPN. Patients were followed up for 18 months or until being diagnosed with lung cancer. Risk and mortality lung cancer were calculated in both groups with Poisson regression.In patients with SPN, incidence of lung cancer was 8.3 % (95 % CI 6.0-11.2) on radiograph and 12.4 % (95 % CI 9.3-15.9) on CT. A chronic obstructive pulmonary disease in patients with radiographs (odds ratio 2.62; 95 % CI 1.03, 6.67) and smoking habit (odds ratio 20.63; 95 % CI 3.84, 110.77) in patients with CT were associated with a higher probability of lung cancer. Large nodule size and spiculated edge were associated with lung cancer on both CT and radiograph. Lung cancer-specific mortality was lower in patients with SPN than in those without SPN (1.73/1000 person-years, 95 % CI 1.08-2.88 vs. 2.15/1000 person-years, 95 % CI 1.25-3.96).The risk of lung cancer for patients with SPN is higher in clinical populations than in screening studies. Moreover, patients with SPN showed lower mortality than those without SPN.aEuro cent Lung cancer risk is 8 % for SPN detected on routine radiographs.aEuro cent Lung cancer risk is 12.4 % for SPN detected in routine chest CT.aEuro cent Smoking, COPD, SPN diameter and edge were predictors of malignancy.aEuro cent Lung cancer risk of SPN in routine practice seems higher than in screening.