Nie Zhenhui, Vonder Marleen, de Vries Maaike, Yang Xiaofei, Oudkerk Matthijs, Slebos Dirk-Jan, Ye Zhaoxiang, Dorrius Monique D, de Bock Geertruida H
Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Eur Radiol. 2025 Jan 2. doi: 10.1007/s00330-024-11231-3.
To assess the co-occurrence of incidental CT lung findings (emphysema, bronchiectasis, and airway wall thickening) as well as associated risk factors in low-dose CT (LDCT) lung cancer screening in a Chinese urban population.
Data from 978 participants aged 40-74 years from the Chinese NELCIN-B3 urban population study who underwent LDCT screening were selected. CT scans were reviewed for incidental lung findings: emphysema, bronchiectasis and airway wall thickness. Emphysema was defined in three ways (≥ trace, ≥ mild, or ≥ moderate) depending on severity. Participants were described and stratified by presence or absence of incidental lung findings. Logistic regression analyses were performed to examine the relationship between participant characteristics and CT findings.
Mean age was 61.3 years ± 6.8 and 533 (54.6%) were female. 48% of participants had incidental lung findings: 19.9% had emphysema (≥ mild), 9.2% had bronchiectasis, and 35.7% had airway wall thickening. Among 978 participants, 2.1% showed all three findings. Multivariable analysis showed that higher age (OR: 1.06; 95% CI: 1.04-1.08; p < 0.001), male sex (OR: 1.68; 95% CI: 1.14-2.47; p = 0.008) smoking history (OR: 1.76; 95% CI: 1.02-3.03; p = 0.04 for former smokers; OR: 2.45; 95% CI: 1.59-3.78; p < 0.001 for current smokers), and the presence of respiratory symptoms (OR: 1.42; 95% CI: 1.01-2.00; p = 0.04) were associated with the risk of having at least one incidental lung findings. When different definitions of emphysema were used, the results remained consistent.
In a Chinese urban population undergoing LDCT lung cancer screening, 48% had at least one incidental CT lung finding, which was associated with higher age, male sex, questionnaire-based respiratory symptoms and smoking history.
Question Reporting of incidental lung findings that indicate lung disease risk lacks consensus in the cancer screening setting and needs evidence of co-occurrence in general populations. Findings Almost half of the 978 participants had at least one incidental lung CT finding; these were associated with older age, male sex, respiratory symptoms, and smoking history. Clinical relevance Incidental lung findings and related risk factors are often observed in low-dose CT lung cancer screening, and careful consideration of their relevance should be given to their inclusion in future screenings.
评估中国城市人群低剂量CT（LDCT）肺癌筛查中偶然发现的肺部CT表现（肺气肿、支气管扩张和气道壁增厚）的共存情况以及相关危险因素。
选取中国NELCIN-B3城市人群研究中978名年龄在40-74岁接受LDCT筛查的参与者的数据。对CT扫描结果进行回顾，以确定是否存在偶然的肺部表现：肺气肿、支气管扩张和气道壁厚度。根据严重程度，肺气肿以三种方式定义（≥微量、≥轻度或≥中度）。根据是否存在偶然的肺部表现对参与者进行描述和分层。进行逻辑回归分析，以检验参与者特征与CT表现之间的关系。
平均年龄为61.3岁±6.8岁，女性533名（54.6%）。48%的参与者有偶然的肺部表现：19.9%有肺气肿（≥轻度），9.2%有支气管扩张，35.7%有气道壁增厚。在978名参与者中，2.1%的人三种表现均有。多变量分析显示，年龄较大（比值比：1.06；95%置信区间：1.04-1.08；p<0.001）、男性（比值比：1.68；95%置信区间：1.14-2.47；p=0.008）、吸烟史（比值比：1.76；95%置信区间：1.02-3.03；既往吸烟者p=0.04；比值比：2.45；95%置信区间：1.59-3.78；当前吸烟者p<0.001）以及存在呼吸道症状（比值比：1.42；95%置信区间：1.01-2.00；p=0.04）与至少有一种偶然肺部表现的风险相关。当使用不同的肺气肿定义时，结果仍然一致。
在中国城市人群进行LDCT肺癌筛查中，48%的人至少有一项偶然的肺部CT表现，这与年龄较大、男性、基于问卷的呼吸道症状和吸烟史有关。
问题 在癌症筛查环境中，关于提示肺部疾病风险的偶然肺部表现的报告缺乏共识，需要一般人群中共存情况的证据。发现 在978名参与者中，近一半至少有一项偶然的肺部CT表现；这些与年龄较大、男性、呼吸道症状和吸烟史有关。临床意义 在低剂量CT肺癌筛查中经常观察到偶然的肺部表现和相关危险因素，在未来的筛查中应仔细考虑它们的相关性并将其纳入。
