Diagnostic Value on Lung Cancer Screening using Low-dose Spiral CT / 实用放射学杂志

ABSTRACT

Objective To evaluate the possibility and efficiency of early lung cancer screening using low-dose spiral CT,and to investigate the effects of prognosis of lung cancer. Methods 3005 routine chests check-up were carried on the low-dose prospect research of the SHIMADZU 7800 TX spiral CT. According to the result by tracing and long-term CT follow-up based on the baseline screening, biopsy or surgical excisions were recommended in "malignant change" or enlarged nodules. Two doctors separately interpreted all the images blindly.Results 29.9 rate of nodules in all of cases were detected. Smoking group was 1.3 times incidence of non-smoking. A whole incidence of lung cancer was 1.2, including 2.9 in people at high risk of lung cancer and 0.9 in common people. The sensitivity and specificity of lung cancer screening using low-dose spiral CT were 82.9 and 88.8 respectively, and the diagnostic accuracy of lung cancer screening in diameter of nodules less than 10 mm was high than in ones more than 10 mm. Histologically, 33 non-small cell lung cancers (19 stageⅠ, 10 stageⅡand 4 stageⅢ), 2 small cell lung cancers and 1 scar carcinoma were proved based on baseline screening by biopsy or surgery. By the end of 2007, the average survival for clinical stageⅠlung cancer was more than 4 years, clinical stageⅡwas 2～3 years and clinical stageⅢ was 1～2 years. Conclusion Low-dose spiral CT is of high sensitive and specificity in detecting early lung cancer. Preliminary screening study indicates that low-dose spiral CT can greatly improve the likelihood of detection for early lung cancer and situation of survival.