隐匿性肺癌的筛查

Barclay T H, MacIntosh J H

Can Med Assoc J. 1983 Apr 15;128(8):940-4.

A pilot screening program for the early detection of lung cancer was carried out in Saskatchewan in 1968 using chest roentgenography and cytologic examination of sputum samples. The yield from 23 000 men aged 40 years and over was only 10 cases. Nine of the men had advanced disease. One had occult lung cancer. A period of 31 months elapsed between the discovery of malignant cells in this patient's sputum and roentgenographic localization of the tumour. Following pneumonectomy he has survived with no discernible residual or metastatic tumour for 12 years. The morphologic changes in the resected lung provided a basis for discussing the preclinical phase of squamous cancer of the lung, the treatment of occult cancer and multicentric primary pulmonary tumours. The survey would have been more successful with a narrower target group and more frequent examination.

1968年在萨斯喀彻温省开展了一项肺癌早期检测的试点筛查项目，采用胸部X线摄影和痰标本细胞学检查。对23000名40岁及以上男性的筛查结果仅发现10例病例。其中9名男性患有晚期疾病。1名患有隐匿性肺癌。该患者痰中发现恶性细胞与肿瘤的X线定位之间间隔了31个月。肺切除术后，他已存活12年，未发现明显的残留或转移性肿瘤。切除肺的形态学变化为讨论肺鳞状细胞癌的临床前期、隐匿性癌的治疗以及多中心原发性肺肿瘤提供了依据。如果目标群体更窄且检查更频繁，该调查可能会更成功。