Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Lung Cancer. 2023 Jul;181:107262. doi: 10.1016/j.lungcan.2023.107262. Epub 2023 May 27.
The present study, CLUS version 2.0, was conducted to evaluate the performance of new techniques in improving the implementation of lung cancer screening and to validate the efficacy of LDCT in reducing lung cancer-specific mortality in a high-risk Chinese population.
From July 2018 to February 2019, high-risk participants from six screening centers in Shanghai were enrolled in our study. Artificial intelligence, circulating molecular biomarkers and autofluorescencebronchoscopy were applied during screening.
A total of 5087 eligible high-risk participants were enrolled in the study; 4490 individuals were invited, and 4395 participants (97.9%) finally underwent LDCT detection. Positive screening results were observed in 857 (19.5%) participants. Solid nodules represented 53.6% of all positive results, while multiple nodules were the most common location type (26.8%). Up to December 2020, 77 participants received lung resection or biopsy, including 70 lung cancers, 2 mediastinal tumors, 1 tracheobronchial tumor, 1 malignant pleural mesothelioma and 3 benign nodules. Lung cancer patients accounted for 1.6% of all the screened participants, and 91.4% were in the early stage (stage 0-1).
LDCT screening can detect a high proportion of early-stage lung cancer patients in a Chinese high-risk population. The utilization of new techniques would be conducive to improving the implementation of LDCT screening.
本研究（CLUS 版本 2.0）旨在评估新技术在提高肺癌筛查实施效果方面的表现，并验证低剂量 CT（LDCT）在降低中国高危人群肺癌特异性死亡率方面的疗效。
2018 年 7 月至 2019 年 2 月，来自上海 6 个筛查中心的高危参与者纳入本研究。在筛查过程中应用了人工智能、循环分子生物标志物和自体荧光支气管镜检查。
共有 5087 名符合条件的高危参与者纳入研究；共邀请了 4490 人，最终有 4395 名参与者（97.9%）接受了 LDCT 检测。857 名（19.5%）参与者的筛查结果呈阳性。实性结节占所有阳性结果的 53.6%，而多个结节是最常见的部位类型（26.8%）。截至 2020 年 12 月，77 名参与者接受了肺切除术或活检，包括 70 例肺癌、2 例纵隔肿瘤、1 例气管支气管肿瘤、1 例恶性胸膜间皮瘤和 3 例良性结节。肺癌患者占所有筛查参与者的 1.6%，91.4%处于早期（0-1 期）。
LDCT 筛查可以在中国高危人群中检测出较高比例的早期肺癌患者。新技术的应用将有助于提高 LDCT 筛查的实施效果。
