Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China.
State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Chengdu, China.
Thorac Cancer. 2024 Jul;15(19):1522-1532. doi: 10.1111/1759-7714.15383. Epub 2024 May 27.
Lung cancer is one of the most common malignant tumors threatening human life and health. At present, low-dose computed tomography (LDCT) screening for the high-risk population to achieve early diagnosis and treatment of lung cancer has become the first choice recommended by many authoritative international medical organizations. To further optimize the lung cancer screening method, we conducted a real-world study of LDCT lung cancer screening in a large sample of a healthy physical examination population, comparing differences in lung nodules and lung cancer detection between thin and thick-slice LDCT scanning.
A total of 29 296 subjects who underwent low-dose thick-slice CT scanning (5 mm thickness) from January 2015 to December 2015 and 28 058 subjects who underwent low-dose thin-slice CT scanning (1 mm thickness) from January 2018 to December 2018 in West China Hospital were included. The positive detection rate, detection rate of lung cancer, pathological stage of lung cancer, and mortality rate of lung cancer were analyzed and compared between the two groups.
The positive rate of LDCT screening in the thin-slice scanning group was significantly higher than that in the thick-slice scanning group (20.1% vs. 14.4%, p < 0.001). In addition, the lung cancer detection rate in the thin-slice LDCT screening positive group was significantly higher than that in the thick-slice scanning group (78.0% vs. 52.9%, p < 0.001).
The screening positive rate of low-dose thin-slice CT scanning is higher and more early-stage lung cancer (IA1 stage) can be detected in the screen-positive group.
肺癌是威胁人类生命健康的最常见恶性肿瘤之一。目前,对高危人群进行低剂量计算机断层扫描(LDCT)筛查,以实现肺癌的早期诊断和治疗,已成为许多权威国际医学组织推荐的首选方法。为了进一步优化肺癌筛查方法,我们对大量健康体检人群进行了 LDCT 肺癌筛查的真实世界研究,比较了薄层和厚层 LDCT 扫描在肺结节和肺癌检出方面的差异。
纳入 2015 年 1 月至 12 月期间行低剂量厚层 CT 扫描(5mm 层厚)的 29296 例受试者和 2018 年 1 月至 12 月期间行低剂量薄层 CT 扫描(1mm 层厚)的 28058 例受试者。分析比较两组的阳性检出率、肺癌检出率、肺癌病理分期和肺癌死亡率。
薄层扫描组 LDCT 筛查的阳性率明显高于厚层扫描组(20.1%比 14.4%,p<0.001)。此外,薄层 LDCT 筛查阳性组的肺癌检出率明显高于厚层扫描组(78.0%比 52.9%,p<0.001)。
低剂量薄层 CT 扫描的筛查阳性率更高,在筛查阳性组中可以发现更多早期肺癌(IA1 期)。