Department of Thoracic Surgery, Chigasaki Municipal Hospital, Chigasaki, Kanagawa, Japan.
Department of Respiratory Medicine, Chigasaki Municipal Hospital, Chigasaki, Kanagawa, Japan.
Cancer Rep (Hoboken). 2018 Oct;1(3):e1124. doi: 10.1002/cnr2.1124. Epub 2018 Jul 26.
People with occupational exposure to asbestos demonstrate a high incidence of lung cancer. Asbestos medical examination for those at risk was implemented as a national policy in Japan. This study aimed to characterize patients with asbestos-related lung cancer who were diagnosed by these examinations.
We retrospectively investigated 120 individuals exposed to asbestos who were examined from 2008 to 2016 at our institution. Clinical data, including CT findings and time-related exposure variables, were evaluated. Each asbestos-related change was assigned 1 point if present, and the scores were compared between patients with and without asbestos-related lung cancer using the Mann-Whitney U test and Fisher's exact test.
Five patients were diagnosed with lung cancer, and four underwent surgical treatment. At the time of writing, three of four operated patients were alive without recurrence, with a similar prognosis to patients with lung cancer unrelated to asbestos. Average scores for asbestos-related findings on CT Scan were 1.8 (9/5) for patients with lung cancer and 0.79 (91/115) for those without lung cancer.
Patients with lung cancer had significantly more asbestos-related changes on CT scan than those without lung cancer. Concurrent calcified plaque and interstitial changes might be a predictor of lung cancer incidence. Although further investigation with a larger study group is needed, regular medical examination and CT scan every 6 months might contribute to the early detection of lung cancer with asbestos-related changes on CT.
有石棉职业暴露史的人群肺癌发病率较高。日本将针对高危人群的石棉医学检查纳入国家政策。本研究旨在对通过这些检查诊断为与石棉相关的肺癌患者的特征进行分析。
我们回顾性调查了 2008 年至 2016 年在我院接受检查的 120 名接触石棉的个体。评估了包括 CT 发现和与时间相关的暴露变量在内的临床数据。如果存在任何与石棉相关的改变，则为每个改变计 1 分，并使用 Mann-Whitney U 检验和 Fisher 确切检验比较有和无与石棉相关的肺癌患者的评分。
5 名患者被诊断为肺癌，其中 4 名接受了手术治疗。截至撰写本文时，4 名接受手术的患者中有 3 名存活且无复发，其预后与与石棉无关的肺癌患者相似。肺癌患者 CT 扫描上石棉相关表现的平均评分是 1.8（9/5），而无肺癌患者的平均评分为 0.79（91/115）。
肺癌患者 CT 扫描上石棉相关改变的数量明显多于无肺癌患者。同时存在钙化斑块和间质性改变可能是肺癌发病率的预测因素。尽管需要进一步的大样本研究来证实，但定期的医学检查和每 6 个月的 CT 扫描可能有助于对 CT 上有石棉相关改变的肺癌进行早期发现。
