Swensen Stephen J, Jett James R, Hartman Thomas E, Midthun David E, Sloan Jeff A, Sykes Anne-Marie, Aughenbaugh Gregory L, Clemens Medy A
Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Radiology. 2003 Mar;226(3):756-61. doi: 10.1148/radiol.2263020036. Epub 2003 Jan 24.
To evaluate a large cohort of patients at high risk for lung cancer by using screening with low-dose spiral computed tomography (CT) of the chest.
A prospective cohort study was performed with 1,520 individuals aged 50 years or older who had smoked 20 pack-years or more. Participants underwent three annual low-dose CT examinations of the chest and upper abdomen. Characteristics of pulmonary nodules and additional findings were tabulated and analyzed.
Two years after baseline CT scanning, 2,832 uncalcified pulmonary nodules were identified in 1,049 participants (69%). Forty cases of lung cancer were diagnosed: 26 at baseline (prevalence) CT examinations and 10 at subsequent annual (incidence) CT examinations. CT alone depicted 36 cases; sputum cytologic examination alone, two. There were two interval cancers. Cell types were as follows: squamous cell tumor, seven; adenocarcinoma or bronchioloalveolar carcinoma, 24; large cell tumor, two; non-small cell tumor, three; small cell tumor, four. The mean size of the non-small cell cancers detected at CT was 15.0 mm. The stages were as follows: IA, 22; IB, three; IIA, four; IIB, one; IIIA, five; IV, one; limited small cell tumor, four. Twenty-one (60%) of the 35 non-small cell cancers detected at CT were stage IA at diagnosis. Six hundred ninety-six additional findings of clinical importance were identified.
CT can depict early-stage lung cancers. The rate of benign nodule detection is high.
通过胸部低剂量螺旋计算机断层扫描（CT）筛查来评估一大群肺癌高危患者。
对1520名年龄在50岁及以上、吸烟史达20包年或更长时间的个体进行了一项前瞻性队列研究。参与者每年接受三次胸部和上腹部低剂量CT检查。将肺结节的特征和其他检查结果制成表格并进行分析。
在基线CT扫描两年后，1049名参与者（69%）中发现了2832个未钙化的肺结节。确诊肺癌40例：基线（患病率）CT检查时26例，随后年度（发病率）CT检查时10例。仅CT检查发现36例；仅痰细胞学检查发现2例。有2例为间期癌。细胞类型如下：鳞状细胞癌7例；腺癌或细支气管肺泡癌24例；大细胞癌2例；非小细胞癌3例；小细胞癌4例。CT检测到的非小细胞癌的平均大小为15.0毫米。分期如下：IA期22例；IB期3例；IIA期4例；IIB期1例；IIIA期5例；IV期1例；局限期小细胞癌4例。CT检测到的35例非小细胞癌中，21例（60%）在诊断时为IA期。还发现了696项具有临床意义的其他检查结果。
CT能够检测出早期肺癌。良性结节的检出率很高。
