Omori Hisamitsu, Nakashima Rumi, Otsuka Nobuko, Mishima Yoshiko, Tomiguchi Seigi, Narimatsu Akiko, Nonami Yoshio, Mihara Shuichi, Koyama Wasaku, Marubayashi Tohru, Morimoto Yasuo
Japanese Red Cross Kumamoto Health Care Center, Nagamineminami, Kumakoto, Japan.
Respirology. 2006 Mar;11(2):205-10. doi: 10.1111/j.1440-1843.2006.00827.x.
Screening with low-dose spiral CT is a promising new tool for early lung cancer detection. A study was undertaken to assess the prevalence of emphysema detected by CT screening, and to assess the correlation between the extent of emphysema and the severity defined according to the recently published Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria.
After informed consent, CT screening and pulmonary function tests were performed on 615 men between the ages of 40 and 69. Severity of emphysema was assessed visually. Only the pulmonary function data for male subjects were analysed because there were too few female subjects with emphysema.
Emphysema was detected in 30.5% of current smokers, 14.1% of former smokers and 3.0% of non-smokers. In male current smokers, airflow obstruction (FEV(1)/FVC < 0.7) was seen in 18.1% of subjects with mild emphysema, and in 33.3% of subjects with moderate emphysema. FEV(1) values were less than 80% of the predicted normal in 8.5% of subjects with mild emphysema, and 28.6% of subjects with moderate emphysema. The percentage of male subjects with emphysema equivalent to GOLD stage 0 was 90.0% for subjects in their 40s, 82.5% for those in their 50s, and 68.2% for those in their 60s.
A considerable percentage of the subjects with emphysema as detected by CT screening had GOLD stage 0. CT screening assists in detecting early-stage emphysema.
低剂量螺旋CT筛查是一种很有前景的早期肺癌检测新工具。本研究旨在评估CT筛查所检测出的肺气肿患病率，并评估肺气肿程度与根据最近发布的慢性阻塞性肺疾病全球倡议（GOLD）标准所定义的严重程度之间的相关性。
在获得知情同意后，对615名年龄在40至69岁之间的男性进行了CT筛查和肺功能测试。通过视觉评估肺气肿的严重程度。由于患肺气肿的女性受试者过少，因此仅分析了男性受试者的肺功能数据。
当前吸烟者中肺气肿的检出率为30.5%，既往吸烟者中为14.1%，非吸烟者中为3.0%。在男性当前吸烟者中，轻度肺气肿受试者中有18.1%出现气流受限（FEV(1)/FVC < 0.7），中度肺气肿受试者中有33.3%出现气流受限。轻度肺气肿受试者中有8.5%的FEV(1)值低于预测正常值的8%，中度肺气肿受试者中有28.6%的FEV(1)值低于预测正常值的8%。40多岁的男性肺气肿受试者中相当于GOLD 0期的比例为90.0%，50多岁的为82.5%，60多岁的为68.2%。
CT筛查所检测出的肺气肿受试者中有相当比例处于GOLD 0期。CT筛查有助于早期肺气肿的检测。
