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中国安徽一家三级医院进行的低剂量 CT 肺癌筛查,以及试验数据的二次分析。

Lung cancer screening with low-dose computed tomography at a tertiary hospital in Anhui, China and secondary analysis of trial data.

机构信息

Department of Laboratory Diagnostics, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.

出版信息

Br J Radiol. 2021 Feb 1;94(1118):20200438. doi: 10.1259/bjr.20200438. Epub 2020 Dec 22.

Abstract

OBJECTIVE

Lung cancer screening with low-dose computed tomography (LDCT) partly reduces cancer-specific mortality. However, few data have described this specific population for screening in mainland China. Here, we conducted a population-based screening program in Anhui, China.

METHODS

9084 individuals were participating in the screening program for lung cancer in Anhui province from 1 June 2014 to 31 May 2017. LDCT was offered to all participants who joined the program.

RESULTS

Of 9084 individuals undergoing LDCT, we detected 54 lung cancers (0.594%). The age with the highest rate was 61-65 years (up to 1.016%), followed by 56-60 (0.784%). Most patients (98.1%, 53/54) were in stage I-II (early stage), and only one was in stage III (advanced stage). Adenocarcinoma, squamous cell carcinoma and small cell lung cancer accounted for 57.4% (31/54), 37% (20/54) and 5.6% (3/54) of the individuals, respectively. Notably, There were 4,102 never smokers in our study. The median age was 63 years. Males and females accounted for 53.4 and 46.6%, respectively. Among the 4102 never smokers, 96 participants had a positive family cancer history. Additionally, we detected 20 lung cancers (0.488%), slightly lower than the whole rate 0.594%. Finally, our data showed that age, smoking, family cancer history and features of nodules were risk factors for lung cancer.

CONCLUSION

Our study qualified the efficiency of LDCT to detect early-stage lung cancers in Anhui, China. Further establishment of appropriate lung cancer screening methods specifically for individuals in China is warranted.

ADVANCES IN KNOWLEDGE

We evaluated the performance of lung cancer screening for asymptomatic populations using LDCT in Anhui, an eastern inland province of China. Our study qualified the efficiency of LDCT to detect early-stage lung cancers in Anhui, China.

摘要

目的

低剂量计算机断层扫描(LDCT)在肺癌筛查中降低了癌症特异性死亡率。然而,针对中国大陆的这一特定人群,关于这方面的研究数据很少。在此,我们在中国安徽开展了一项基于人群的筛查项目。

方法

2014 年 6 月 1 日至 2017 年 5 月 31 日,9084 名个体参加了安徽省的肺癌筛查项目。所有参加该项目的个体均接受 LDCT 检查。

结果

在接受 LDCT 检查的 9084 名个体中,我们检测出 54 例肺癌(0.594%)。年龄最高的为 61-65 岁(高达 1.016%),其次是 56-60 岁(0.784%)。大多数患者(98.1%,53/54)处于Ⅰ-Ⅱ期(早期),仅 1 例处于Ⅲ期(晚期)。腺癌、鳞状细胞癌和小细胞肺癌分别占 57.4%(31/54)、37%(20/54)和 5.6%(3/54)。值得注意的是,在我们的研究中,有 4102 名从未吸烟者。中位年龄为 63 岁,男性和女性分别占 53.4%和 46.6%。在这 4102 名从未吸烟者中,有 96 名有阳性家族癌症史。此外,我们还检测出 20 例肺癌(0.488%),略低于整体检出率 0.594%。最后,我们的数据表明,年龄、吸烟、家族癌症史和结节特征是肺癌的危险因素。

结论

我们的研究证明了在安徽使用 LDCT 检测早期肺癌的效率。需要进一步建立适合中国人群的肺癌筛查方法。

知识进展

我们评估了在安徽使用 LDCT 对无症状人群进行肺癌筛查的效果,安徽是中国东部的一个内陆省份。我们的研究证明了在安徽使用 LDCT 检测早期肺癌的效率。

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[Risk factors for lung cancer based on low-dose computed tomography screening].基于低剂量计算机断层扫描筛查的肺癌危险因素
Zhonghua Zhong Liu Za Zhi. 2020 Mar 23;42(3):222-227. doi: 10.3760/cma.j.cn112152-20190809-00509.

本文引用的文献

3
Lung Cancer Screening with Low-Dose CT: Baseline Screening Results in Shanghai.低剂量 CT 肺癌筛查:上海基线筛查结果。
Acad Radiol. 2019 Oct;26(10):1283-1291. doi: 10.1016/j.acra.2018.12.002. Epub 2018 Dec 14.
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Cancer statistics, 2018.癌症统计数据,2018 年。
CA Cancer J Clin. 2018 Jan;68(1):7-30. doi: 10.3322/caac.21442. Epub 2018 Jan 4.
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Lung cancer screening: latest developments and unanswered questions.肺癌筛查:最新进展与未解问题。
Lancet Respir Med. 2016 Sep;4(9):749-761. doi: 10.1016/S2213-2600(16)30200-4.
8
CT screening for lung cancer: Is the evidence strong enough?CT筛查肺癌:证据是否足够充分?
Lung Cancer. 2016 Jan;91:29-35. doi: 10.1016/j.lungcan.2015.11.003. Epub 2015 Nov 30.

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