Kanashiki Maki, Tomizawa Takuji, Yamaguchi Iwao, Kurishima Koichi, Hizawa Nobuyuki, Ishikawa Hiroichi, Kagohashi Katsunori, Satoh Hiroaki
Ibaraki Health Service Association, Tsukuba, Japan.
Oncol Lett. 2012 Sep;4(3):513-516. doi: 10.3892/ol.2012.780. Epub 2012 Jun 28.
The aim of this study was to evaluate the volume doubling time (VDT) of lung cancer detected in our annual chest radiograph screening program and to compare it with those previously reported for computed tomography (CT) screening. In total, 209 patients who had a measurable tumor shadow and a history of participating in our chest radiograph mass screening program between 2006 and 2009 were included in this study. Indirect roentgenograms for patients with lung cancer were converted into digital images, and the section showing the tumor was enlarged on the monitor to a size of 0.01 mm. The mean VDT for all the patients was 158 days. Only 3.8% of the patients had a VDT of more than 400 days. In 140 patients with adenocarcinoma, the mean VDT was 177 days, and 5.0% of these patients had a VDT of more than 400 days. In the 44 patients with squamous cell carcinoma, the mean VDT was 133 days, and only 2.3% of these patients had a VDT of more than 400 days. These results were different from those previously reported for CT screening. In several reports on CT screening, more than 20% of the lung cancers had VDTs of more than 400 days. Since it is common knowledge that there are 'indolent' lung cancers with a VDT of more than 400 days, screening by annual chest radiography with rare overdiagnosis may need to be reconsidered.
本研究的目的是评估在我们的年度胸部X线筛查项目中检测到的肺癌的体积倍增时间（VDT），并将其与先前报道的计算机断层扫描（CT）筛查结果进行比较。本研究共纳入了209例在2006年至2009年间有可测量肿瘤阴影且有参与我们胸部X线大规模筛查项目病史的患者。将肺癌患者的间接X线片转换为数字图像，并在显示器上放大显示肿瘤的切片至0.01mm大小。所有患者的平均VDT为158天。只有3.8%的患者VDT超过400天。在140例腺癌患者中，平均VDT为177天，其中5.0%的患者VDT超过400天。在44例鳞状细胞癌患者中，平均VDT为133天，其中只有2.3%的患者VDT超过400天。这些结果与先前报道的CT筛查结果不同。在几份关于CT筛查的报告中，超过20%的肺癌VDT超过400天。由于众所周知存在VDT超过400天的“惰性”肺癌，因此可能需要重新考虑每年进行胸部X线筛查且很少过度诊断的情况。
