RESUMO
OBJECTIVE: To explore the application value of low-dose spiral computed tomography (LDCT) in lung cancer screening. METHODS: A total of 2251 asymptomatic subjects undergoing chest LDCT scan at Center of Physical Examination, Affiliated Zhongshan Hospital, Fudan University between June 2011 and December 2012 were prospectively enrolled. The incidence rates of lung nodule and lung cancer were analyzed to compare the value of LDCT screening in subjects with smoking-related high, medium and low risks of lung cancer. The value of serum tumor biomarker in the reduction of false positive of LDCT was also discussed. RESULTS: Among all subjects, 9.9% (222/2251) displayed at least 1 non-calcified nodule with a diameter ≥ 4 mm. Two subjects were diagnosed with lung cancer and 1 of them received surgical resection. Other subjects with lung nodules were followed. There was no statistical difference in the incidence rates of lung nodule between the high, medium and low-risk groups of lung cancer associated with smoking (8.8%, 9.5% and 10.1%, P = 0.864). The incidence rates of lung nodule in subjects ≥ 55 years old were higher than that of those <55 years old (12.7% vs 9.1%, P = 0.034). Female gender had a high risk of ground glass opacity (GGO) or ground glass nodule (GGN) (P = 0.015). The independent or combined increase of serum tumor biomarkers of carcinoembryonic antigen (CEA), neuron specific enolase (NSE), cytokeratin fragment 21-1 (Cyfra211) and squamous cell carcinoma antigen (SCC) might not predicate the incidence of lung nodule. CONCLUSION: LDCT screening is highly valuable in lung cancer screening.