Marrer Émilie, Jolly Damien, Arveux Patrick, Lejeune Catherine, Woronoff-Lemsi Marie-Christine, Jégu Jérémie, Guillemin Francis, Velten Michel
Department of Epidemiology and Public Health, Faculty of medicine, EA 3430, Strasbourg University, Strasbourg, France.
Clinical research Coordination, University Hospital, Reims, France.
BMC Cancer. 2017 Jan 11;17(1):47. doi: 10.1186/s12885-016-3029-z.
The discovery of a solitary pulmonary nodule (SPN) on a chest imaging exam is of major clinical concern. However, the incidence rates of SPNs in a general population have not been estimated. The objective of this study was to provide incidence estimates of SPNs in a general population in 5 northeastern regions of France.
This population-based study was undertaken in 5 regions of northeastern France in May 2002-March 2003 and May 2004-June 2005. SPNs were identified by chest CT reports collected from all radiology centres in the study area by trained readers using a standardised procedure. All reports for patients at least 18 years old, without a previous history of cancer and showing an SPN between 1 and 3 cm, were included.
A total of 11,705 and 20,075 chest CT reports were collected for the 2002-2003 and 2004-2005 periods, respectively. Among them, 154 and 297 reports showing a SPN were included, respectively for each period. The age-standardised incidence rate (IR) was 10.2 per 100,000 person-years (95% confidence interval 8.5-11.9) for 2002-2003 and 12.6 (11.0-14.2) for 2004-2005. From 2002 to 2005, the age-standardised IR evolved for men from 16.4 (13.2-19.6) to 17.7 (15.0-20.4) and for women from 4.9 (3.2-6.6) to 8.2 (6.4-10.0). In multivariate Poisson regression analysis, gender, age, region and period were significantly associated with incidence variation.
This study provides reference incidence rates of SPN in France. Incidence was higher for men than women, increased with age for both gender and with time for women. Trends in smoking prevalence and improvement in radiological equipment may be related to incidence variations.
胸部影像学检查发现孤立性肺结节（SPN）是临床主要关注的问题。然而，普通人群中SPN的发病率尚未得到估计。本研究的目的是提供法国东北部5个地区普通人群中SPN的发病率估计值。
这项基于人群的研究于2002年5月至2003年3月以及2004年5月至2005年6月在法国东北部的5个地区进行。通过训练有素的阅片者使用标准化程序从研究区域内所有放射科中心收集的胸部CT报告来识别SPN。纳入所有年龄至少18岁、无癌症病史且显示有1至3厘米SPN的患者报告。
在2002 - 2003年和2004 - 2005年期间，分别收集了11,705份和20,075份胸部CT报告。其中，每个时期分别有154份和297份显示有SPN的报告被纳入。2002 - 2003年年龄标准化发病率（IR）为每10万人年10.2（95%置信区间8.5 - 11.9），2004 - 2005年为12.6（11.0 - 14.2）。从2002年到2005年，男性年龄标准化IR从16.4（13.2 - 19.6）发展到17.7（15.0 - 20.4），女性从4.9（3.2 - 6.6）发展到8.2（6.4 - 10.0）。在多变量泊松回归分析中，性别、年龄、地区和时期与发病率变化显著相关。
本研究提供了法国SPN的参考发病率。男性发病率高于女性，两性发病率均随年龄增长而增加，女性发病率随时间增加。吸烟流行趋势和放射设备的改善可能与发病率变化有关。
