Wilde J, Wilde J, Ganguin H G
Z Erkr Atmungsorgane. 1983;160(2):107-27.
The actual delaying of findings in roentgenograms is represented in 1000 cases of resected bronchial carcinoma from 1957 to 1972 and in 800 unresectable patients from 1973 to 1976. The delaying is analysed using the criteria as localization, site, diameter, histology, clinical delaying of symptoms, manner of discovering the tumour, original finding in the roentgenogram, prognosis, and sex-distribution of the tumours. 1. In 40% of the 1000 resected patients a delay of findings in roentgenograms may be pointed out. 2. Lung cancer is the best discovered by x-ray examination. 69% of 1000 resectable patients, suffering from lung cancer, were discovered by the people's x-ray screening (VRRU). Nevertheless 45-50% of these VRRU-cases are showing a delaying of findings in roentgenograms by more than 6 months. Even in patients, discovered by clinical symptoms, a delaying of findings after x-ray examinations was found, 26% of these patients showing abnormal x-ray findings at the time of diagnosis existing but unheeded already for 6 or more than 24 months. 3. In 10-15% of the cases resection could not be done to delaying of findings in roentgenograms. 4. In most cases the focus of peripheral tumours in roentgenograms is delayed (in 50% for 6 to more than 24 months). 5. In 74% of cases in women a roentgenographic delay was found by 6 to more than 24 months. As a matter of fact, only 10% of all patients were women. 6. Among the central tumours with plain densities the squamous cell carcinomata had findings markedly longer before diagnosis than small cell carcinomata. Among the peripheral tumours alveolar cell carcinoma and adenocell carcinoma are the longest delayed, followed by small (oat) cell carcinoma, polymorph cell carcinoma and squamous cell carcinoma. 7. Positive unheeded x-ray screening series under 6 months remained unregarded in our analysis. But even these series might be still improved. As a conclusion is stated: the detection and prognosis of lung cancer might be improved a) by increasing the quality of reading and interpretation of the VRRU, b) by differentiating the x-ray-intervals according to the risk of lung cancer in each person, c) by a constant algorithm in the diagnosis of suspect findings in roentgenograms.
对1957年至1972年期间1000例接受切除的支气管癌病例以及1973年至1976年期间800例无法切除的患者的X线胸片检查结果延迟情况进行了分析。根据肿瘤的定位、部位、直径、组织学类型、临床症状延迟情况、肿瘤发现方式、X线胸片最初表现、预后以及肿瘤的性别分布等标准对延迟情况进行分析。1. 在1000例接受切除的患者中，40%的患者X线胸片检查结果存在延迟。2. 肺癌通过X线检查最易被发现。1000例可切除的肺癌患者中，69%是通过全民X线筛查（VRRU）发现的。然而，这些VRRU病例中有45% - 50%的患者X线胸片检查结果延迟超过6个月。即使在因临床症状发现的患者中，X线检查后也存在检查结果延迟的情况，这些患者中有26%在诊断时X线检查已发现异常，但当时未被重视，异常情况已存在6个月或超过24个月。3. 10% - 15%的病例因X线胸片检查结果延迟而无法进行切除。4. 在大多数情况下，X线胸片中外周肿瘤的病灶出现延迟（50%的病例延迟6个月至超过24个月）。5. 在74%的女性病例中，X线检查结果延迟6个月至超过24个月。事实上，所有患者中女性仅占10%。6. 在密度均匀的中央型肿瘤中，鳞状细胞癌在诊断前检查结果延迟的时间明显长于小细胞癌。在外周型肿瘤中，肺泡细胞癌和腺细胞癌延迟时间最长，其次是小（燕麦）细胞癌、多形细胞癌和鳞状细胞癌。7. 我们的分析未考虑6个月内未被重视的阳性X线筛查系列。但即使是这些系列仍可能有改进空间。结论如下：提高肺癌的检测和预后可通过以下方式实现：a）提高VRRU阅片和解读质量；b）根据每个人患肺癌的风险区分X线检查间隔时间；c）在诊断X线胸片可疑表现时采用固定算法。
