Dabrowska Marta, Kolasa Anna, Zukowska Małgorzata, Lesiński Jan, Domagała-Kulawik Joanna, Maskey-Warzechowska Marta, Krenke Rafał, Rowiński Olgierd, Chazan Ryszarda
Katedra i Klinika Chorób Wewnetrznych, Pneumonologii i Alergologii Warszawskiego Uniwersytetu Medycznego.
Pneumonol Alergol Pol. 2009;77(1):37-42.
The detection of solitary pulmonary nodules (SPNs) has increased due to widespread use of computed tomography; nevertheless, chest radiographs still remain the basic routine examination. The aim of the study was to estimate the detection of SPNs in routine chest X-rays in hospitalized patients and to assess the incidence of malignancy in newly diagnosed SPNs.
We analyzed 5,726 routine chest radiographs of patients admitted to the Department of Internal Diseases, Pneumology and Allergology in 2004 and 2005. Most of the patients were admitted to hospital due to emergency reasons. The malignant nature of the nodules was confirmed by pathological examination. The nature of benign nodules was confirmed either by pathological examination or based on radiological criteria: no growth within 2 years of radiological follow up, regression in control radiograms or CT scans, benign pattern of calcification.
Among the 5,726 radiograms we found 116 newly diagnosed SPNs (2.2%). Twenty-four nodules (21%) were malignant: NSCLC in 21 cases and metastases in 3 cases. Fifty-one nodules (44%) were benign. In 19 patients (16%) SPNs proved to be artefacts or erroneously interpreted extrathoracic lesions. In 22 cases (19%) there was no final diagnosis (lack of data, diagnostic procedure renunciation).
The incidence of newly detected SPNs in chest X-rays was 2.2%. Most SPNs were benign. About 21% of SPNs were diagnosed as malignant.
由于计算机断层扫描的广泛应用，孤立性肺结节（SPN）的检出率有所增加；然而，胸部X线片仍然是基本的常规检查。本研究的目的是评估住院患者常规胸部X线片中SPN的检出情况，并评估新诊断的SPN中恶性肿瘤的发生率。
我们分析了2004年和2005年内科、肺病学和过敏学系收治患者的5726份常规胸部X线片。大多数患者因急诊入院。结节的恶性性质通过病理检查确诊。良性结节的性质通过病理检查或基于放射学标准确定：放射学随访2年内无生长、对照X线片或CT扫描显示缩小、钙化呈良性模式。
在5726份X线片中，我们发现116个新诊断的SPN（2.2%）。24个结节（21%）为恶性：21例为非小细胞肺癌，3例为转移瘤。51个结节（44%）为良性。19例患者（16%）的SPN被证明是伪影或被错误解释为胸外病变。22例（19%）没有最终诊断结果（缺乏数据、放弃诊断程序）。
胸部X线片中新检测到的SPN的发生率为2.2%。大多数SPN是良性的。约21%的SPN被诊断为恶性。
