摘要
目的评估低剂量螺旋CT肺癌筛查中持续存在肺结节的CT体积和质量的增长及其影响因素。方法回顾性分析2009年3月至2015年12月在中国医学科学院肿瘤医院行≥2次胸部低剂量CT筛查的受检者的CT图像，纳入结节的标准为平均径线≥6mm，将体积增长定义为≥20％。在筛选出的51位受检者（男性26例，女性25例）中，符合条件的肺结节51个，其中非实性结节10个，部分实性结节17个，实性结节24个；高危风险组14个，中危风险组12个，低危风险组25个。应用肺结节分析软件自动测量结节的三维径线、体积和结节体积倍增时间（VDT），计算质量倍增时间（MDT）。结果在体积增长≥20％的51个结节中，平均径线增长≥1．5mm的结节33个，平均径线增长〈1．5mm的结节18个。部分实性结节的中位VDT为364d，低于非实性结节和实性结节（分别为761d和819d），差异均有统计学意义（均P〈0．05）。部分实性结节的中位MDT为351d，低于非实性结节和实性结节（分别为772d和840d），差异均有统计学意义（均P〈0．05）。高危风险组肺结节的中位VDT和MDT分别为181d和256d，均低于低危风险组（分别为1037d和l035d），差异均有统计学意义（均P〈0．05）。VDT与MDT具有相关性（r=0．909，P〈0．001）。结论肺结节的性质和受检者的风险状态均能影响结节的生长，部分实性结节和高危人群的结节生长相对较快，应密切关注。相对于二维径线，体现三维体积和质量变化的VDT和MDT为更早提示结节增长的量化指标。部分实性结节的质量变化早于体积变化。
Objective To evaluate the changes of volume and mass of pulmonary nodules which were detected in low-dose computed tomography （LDCT） screening, and to analyze the influencing factors. Methods This retrospective study analyzed the CT images of the participants who underwent at least two chest LDCT scanning from March 2009 to December 2015 in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. The inclusion criteria was the nodule diameter ≥ 6 mm;the volume growth was defined as ≥ 20%. Fifty-one pulmonary nodules （PNs） were selected among 51 enrolled participants （26 men and 25 women）. According to characteristic of nodule and risk stratification of participant, the nodules were classified into different groups （10 non-solid nodules, 17 part-solid nodules and 24 solid nodules; 14 PNs in high-risk group, 12 PNs in moderate-risk group and 25 PNs in low-risk group）. The Lung-VCAR software was used to measure the diameter and volume of the PNs, and all nodules were calculated for the volume doubling time （VDT） and mass doubling time （MDT）. Results Among the 51 PNs, the diameter of 33 nodules increased more than 1.5 mm while 18 nodules increased less than 1.5 mm. The median VDT of part-solid nodules was 364 days, which was shorter than that of non-solid nodules and solid nodules （761 and 819 days, respectively）, the differences were statistically significant （both P〈 0.05）. The median MDT of part-solid nodules was 351 days, which was lower than that of non-solid nodules and solid nodules （772 days and 840 days, respectively）. The difference was statistically significant （P〈0.05）. The median VDT and MDT of the pulmonary nodules in the high-risk group were 181 days and 256 days, respectively, which were lower than those in the low risk group （1 037 days and 1 035 days, respectively）. VDT has good correlation with MDT （r = 0. 909, P 〈 0. 001 ）. Conclusions Both the characteristic of PNs and the risk status of
作者
孙琦
黄遥
赵世俊
张丽
唐威
金玉晶
吴宁
Sun Qi;Huang Yao;Zhao Shijun;Zhang Li;Tang Wei;Jin Yujing;Wu Ning(Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China)
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2018年第4期274-279,共6页
Chinese Journal of Oncology
基金
国家重点研发计划（2017YFCl308700）
国家科技支撑计划（2014BAl09800）
国家自然科学基金（81701692）
协和青年基金（2017320017）
关键词
肺肿瘤
筛查
低剂量CT
体积
质量
Lung neoplasms
Screening
Low-dose computed tomography
Volume
Mass
