Salomaa E R
Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Preitilä, Finland.
Cancer. 2000 Dec 1;89(11 Suppl):2387-91. doi: 10.1002/1097-0142(20001201)89:11+<2387::aid-cncr12>3.3.co;2-#.
The prognosis of lung carcinoma patients is better when the diagnosis is made early, the disease is localized, and radical surgery is possible. Screening for lung carcinoma with mass radiography or sputum cytology should contribute to a more favorable prognosis. To the author's knowledge to date, large-scale screening studies have shown improved survival but no reduction in mortality.
The histologic tumor type, disease stage, treatment, and survival rates were studied in 93 men who were found to have lung carcinoma during a single chest X-ray screening of > 33,000 smoking men ages 50-69 years and in 239 men of the same age range whose lung carcinoma was detected either through symptomatic presentation or through chest X-ray obtained for other purposes.
The histologic distribution was similar in the two groups but screening detected more early stage tumors that more often were resectable (37% vs. 19%). The 5-year survival rate for the patients detected by screening was 19% and that of the other patients was 10%, with a relative risk 0.65 (95% confidence interval, 0.50-0.84).
The results of the current study demonstrate that chest X-ray screening might improve the prognosis of patients with lung carcinoma. However, these results are subject to many factors that were only partially controlled and should be interpreted cautiously.
肺癌患者若能早期诊断、疾病局限且可行根治性手术，则预后较好。采用胸部X线摄影或痰细胞学检查进行肺癌筛查应有助于改善预后。据作者所知，迄今为止大规模筛查研究显示生存率有所提高，但死亡率并未降低。
对在一次胸部X线筛查中发现肺癌的93名年龄在50 - 69岁的吸烟男性以及239名同年龄范围通过症状表现或因其他目的进行胸部X线检查而发现肺癌的男性的组织学肿瘤类型、疾病分期、治疗及生存率进行了研究。
两组的组织学分布相似，但筛查发现更多早期肿瘤，且这些肿瘤更常可切除（37%对19%）。筛查发现的患者5年生存率为19%，其他患者为10%，相对危险度为0.65（95%可信区间，0.50 - 0.84）。
本研究结果表明胸部X线筛查可能改善肺癌患者的预后。然而，这些结果受多种因素影响，仅部分因素得到控制，应谨慎解读。
