Zhao Yanjie, Wang Ruibin, Shi Feng, Wu Jiangping, Jiang Fusheng, Song Qingkun
Department of Medical Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Department of Emergency, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
Diagnostics (Basel). 2022 Sep 26;12(10):2317. doi: 10.3390/diagnostics12102317.
Background: Since the outbreak of COVID-19 in 2020, routine CT examination was recommended to hospitalized patients at some hospitals and discovered lung cancer patients at an early stage. This study aimed to investigate the detection efficacy of routine CT examination on early diagnosis of lung cancer, especially on pathological characteristics. Methods: The epidemic of COVID-19 outbreak in January 2020 in China, and routine CT examination was recommended to hospitalized patients in June 2020 and ended in July 2021. Based on the time points, we compared the diagnosis efficacy between three periods: pre-period, peri-period, and the period of routine CT examination. Results: During the period of routine CT examination, more early stages of lung cancer were detected and the tumor size was reduced to 2.14 cm from 3.21 cm at pre-period (p = 0.03). The proportion of lung adenocarcinoma and early stage adenocarcinoma was increased by 12% and 30% in the period of routine CT examination, with referral to the pre-period of CT examination (p < 0.05). A total of 61% of diagnosed patients had the wild type of TP53 gene during the period of routine CT examination, compared to 45% of patients at the pre-period of CT examination (p = 0.001). The median Ki-67 index was 15% among patients diagnosed at the period of routine CT examination and increased to 35% at the pre-period of CT examination (p < 0.001). The period of routine CT examination was associated with a 78% higher probability of detecting an early stage of adenocarcinoma (OR = 1.78, 95%CI 1.03, 3.08) but no significant association was observed for squamous cell carcinoma. From the pre-period to the period of routine CT examination, the proportion of female patients and non-smoking patients increased by 57% and 44%, respectively (p < 0.001). Conclusion: Routine CT examination could detect more lung cancer at an early stage, especially for adenocarcinoma, and detect patients with less aggressive features. Further studies were warranted to confirm the findings.
自2020年新型冠状病毒肺炎（COVID-19）疫情爆发以来，一些医院建议对住院患者进行常规CT检查，并早期发现肺癌患者。本研究旨在探讨常规CT检查对肺癌早期诊断的检测效能，尤其是对病理特征的检测效能。方法：2020年1月中国爆发COVID-19疫情，2020年6月建议对住院患者进行常规CT检查，并于2021年7月结束。基于时间点，我们比较了三个时期的诊断效能：前期、围期和常规CT检查期。结果：在常规CT检查期间，检测到更多早期肺癌，肿瘤大小从前期的3.21 cm缩小至2.14 cm（p = 0.03）。与CT检查前期相比，常规CT检查期间肺腺癌和早期腺癌的比例分别增加了12%和30%（p < 0.05）。在常规CT检查期间，共有61%的确诊患者TP53基因呈野生型，而CT检查前期为45%（p = 0.001）。在常规CT检查期间确诊的患者中，Ki-67指数中位数为15%，在CT检查前期升至35%（p < 0.001）。常规CT检查期检测到早期腺癌的概率高78%（OR = 1.78，95%CI 1.03，3.08），但未观察到与鳞状细胞癌有显著关联。从前期到常规CT检查期，女性患者和非吸烟患者的比例分别增加了57%和44%（p < 0.001）。结论：常规CT检查可早期检测出更多肺癌，尤其是腺癌，并检测出侵袭性特征较少的患者。需要进一步研究来证实这些发现。
