Mascalchi Mario, Comin Camilla E, Bertelli Elena, Sali Lapo, Maddau Cristina, Zuccherelli Stefania, Picozzi Giulia, Carrozzi Laura, Grazzini Michela, Fontanini Gabriella, Voltolini Luca, Vella Alessandra, Castiglione Francesca, Carozzi Francesca, Paci Eugenio, Zompatori Maurizio, Lopes Pegna Andrea, Falaschi Fabio
"Mario Serio" Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
Division of Pathological Anatomy, Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy.
J Thorac Dis. 2018 Feb;10(2):1058-1066. doi: 10.21037/jtd.2018.01.95.
Occurrence of multiple primary lung cancers (MPLC) in individuals undergoing low-dose computed tomography (LDCT) screening has not been thoroughly addressed. We investigated MPLC in subjects recruited in the ITALUNG randomized clinical trial. Cases of cytologically/histologically proven MPLC detected at screening LDCT or follow-up CT were selected and pathologically re-evaluated according to the WHO 2015 classification. Overall 16 MPLC were diagnosed at screening LDCT (n=14, all present at baseline) or follow-up CT (n=2) in six subjects (4 in one subject, 3 in two and 2 in three subjects), representing 0.43% of the 1,406 screenees and 15.8% of the 38 subjects with at least one screen-detected primary lung cancer. MPLC included 9 adenocarcinomas in three subjects and a combination of 7 different tumour histotypes in three subjects. MPLC, mostly adenocarcinomas, are not uncommon in smokers and ex-smokers with at least one LDCT screen detected primary lung cancer.
低剂量计算机断层扫描（LDCT）筛查人群中多原发性肺癌（MPLC）的发生情况尚未得到充分研究。我们在ITALUNG随机临床试验招募的受试者中对MPLC进行了调查。选择在筛查LDCT或随访CT时细胞学/组织学证实的MPLC病例，并根据世界卫生组织2015年分类进行病理重新评估。共有6名受试者在筛查LDCT（n = 14，均在基线时存在）或随访CT（n = 2）时诊断出16例MPLC（1名受试者有4个，2名受试者各有3个，3名受试者各有2个），占1406名筛查对象的0.43%，占38名至少有1个筛查发现的原发性肺癌受试者的15.8%。MPLC包括3名受试者的9例腺癌以及3名受试者的7种不同肿瘤组织学类型的组合。MPLC（大多为腺癌）在至少有1个LDCT筛查发现的原发性肺癌的吸烟者和既往吸烟者中并不罕见。
