University Medical Center Groningen, University of Groningen, Dept of Epidemiology, Groningen, the Netherlands.
University Medical Center Groningen, University of Groningen, Dept of Radiology, Groningen, the Netherlands.
Eur J Radiol. 2022 Sep;154:110410. doi: 10.1016/j.ejrad.2022.110410. Epub 2022 Jun 14.
Aim was to assess CT characteristics of lung nodules in never and former smokers compared to current smokers in a population-based setting.
We included individuals aged 45-60 years taking part in the ImaLife (Imaging in Lifelines) study, with at least one solid lung nodule (≥30 mm) on low-dose chest CT. Qualitative (location, shape, margin, nodule type, attached structures) and quantitative (count, diameter, volume) nodule characteristics were evaluated. Based on Fleischner criteria, 'high risk' nodules were defined. To examine the association between smoking status and nodule CT characteristics of participants, multi-level multinomial logistic regression corrected for clustering of nodules within participants was performed, where all odds ratios (aORs) were adjusted for age and sex.
Overall, 1,639 individuals (median age: 55.0, IQR:50.5-58.5, 50.5% men) were included, with 42.1% never smokers, 35.3% former smokers and 22.6% current smokers. A total of 3,222 solid nodules were identified; 39.7% of individuals had multiple nodules. Nodule size, location, type and attachment were similar for never compared to current smokers. The odds of nodules with an irregular shape and irregular margin was lower in never smokers (aOR:0.64, 95 %CI:0.44-0.93; aOR:0.60, 95 %CI:0.41-0.88, respectively) and former smokers (aOR:0.61, 95 %CI:0.41-0.90; aOR:0.57, 95 %CI:0.38-0.85, respectively) compared to current smokers. The odds of a detected nodule being 'high risk' was similar for never versus current smokers (never smokers: aOR = 0.90; 95% CI:0.73-1.11).
CT-based characteristics of solid lung nodules in never and former smokers differed only slightly from current smokers. Among individuals with solid nodules, 'high-risk' nodules were equally common in never smokers and current smokers.
旨在评估基于人群的从不吸烟者和前吸烟者与当前吸烟者的肺结节 CT 特征。
我们纳入了年龄在 45-60 岁之间的 ImaLife（Lifelines 影像学）研究参与者，这些参与者在低剂量胸部 CT 上至少有一个实性肺结节（≥30mm）。评估了结节的定性特征（位置、形状、边缘、结节类型、附着结构）和定量特征（数量、直径、体积）。根据 Fleischner 标准，定义了“高危”结节。为了研究吸烟状况与参与者肺结节 CT 特征之间的关系，对参与者内结节的聚类进行了校正的多水平多项逻辑回归分析，所有比值比（aOR）均按年龄和性别进行了调整。
共纳入 1639 名参与者（中位年龄：55.0，IQR：50.5-58.5，50.5%为男性），其中 42.1%为从不吸烟者，35.3%为前吸烟者，22.6%为当前吸烟者。共发现 3222 个实性结节；39.7%的参与者有多发性结节。与当前吸烟者相比，从不吸烟者的结节大小、位置、类型和附着方式相似。无吸烟史者结节形状不规则和边缘不规则的可能性较低（aOR：0.64，95%CI：0.44-0.93；aOR：0.60，95%CI：0.41-0.88），前吸烟者（aOR：0.61，95%CI：0.41-0.90；aOR：0.57，95%CI：0.38-0.85）与当前吸烟者相比。与当前吸烟者相比，从不吸烟者与当前吸烟者的检测结节为“高危”的可能性相似（从不吸烟者：aOR=0.90；95%CI：0.73-1.11）。
从不吸烟者和前吸烟者的实性肺结节 CT 特征与当前吸烟者仅有细微差异。在有实性结节的人群中，从不吸烟者和当前吸烟者的“高危”结节同样常见。
