摘 要
肺癌是全球范围内发病率和死亡率最高的恶性肿瘤之一，早期发现对于提高患者生存率至关重要。传统胸部X线检查在早期肺癌筛查中存在局限性，低剂量螺旋CT（LDCT）作为一种新兴的影像学技术，在降低辐射剂量的同时能够提供高分辨率图像，为早期肺癌筛查提供了新的思路。本研究旨在探讨LDCT在早期肺癌筛查中的应用效果，通过回顾性分析某三甲医院2018 - 2022年期间接受LDCT筛查的5000例无症状人群数据，以同期接受常规胸片检查的5000例人群作为对照组，对比两组在肺部结节检出率、早期肺癌诊断率等方面的差异。结果表明，LDCT组肺部小结节（≤1cm）检出率为32.5%，明显高于胸片组的7.8%；早期肺癌诊断率为1.8%，而胸片组仅为0.4%。进一步分析发现，LDCT对磨玻璃样结节、实性结节等不同类型结节均具有较高的检出能力，且能更准确地评估结节性质。该研究创新性地将LDCT应用于大规模无症状人群筛查，并首次系统比较了其与传统胸片在早期肺癌筛查中的效能差异，证实LDCT可显著提高早期肺癌的检出率，有助于实现肺癌的早诊早治，为制定科学合理的肺癌筛查策略提供了重要依据。
关键词：低剂量螺旋CT；早期肺癌筛查；肺部小结节检出率；早期肺癌诊断率；磨玻璃样结节
Abstract
Lung cancer remains one of the most prevalent and deadliest malignancies globally, and early detection is critical for improving patient survival rates. Traditional chest X-ray examinations have limitations in early lung cancer screening. Low-dose spiral computed tomography (LDCT), as an emerging imaging technology, offers high-resolution images while reducing radiation exposure, providing a novel approach for early lung cancer screening. This study aimed to evaluate the effectiveness of LDCT in early lung cancer screening by retrospectively analyzing data from 5000 asymptomatic individuals who underwent LDCT screening at a tertiary hospital between 2018 and 2022, with another group of 5000 individuals who received conventional chest X-rays during the same period serving as the control. The results demonstrated that the detection rate of small pulmonary nodules (≤1cm) was 32.5% in the LDCT group, significantly higher than 7.8% in the chest X-ray group; the early-stage lung cancer diagnosis rate was 1.8% in the LDCT group compared to only 0.4% in the chest X-ray group. Further analysis revealed that LDCT exhibited superior detection capabilities for various types of nodules, including ground-glass and solid nodules, and provided more accurate assessment of nodule characteristics. This study innovatively applied LDCT to large-scale screening of asymptomatic populations and systematically compared its efficacy with traditional chest X-rays in early lung cancer screening for the first time, confirming that LDCT can substantially increase the detection rate of early-stage lung cancer, facilitating early diagnosis and treatment, and providing crucial evidence for developing scientifically sound lung cancer screening strategies.
Keywords：Low-Dose Spiral Ct；Early Lung Cancer Screening；Pulmonary Nodule Detection Rate；Early Lung Cancer Diagnosis Rate；Ground-Glass Nodule
目 录
摘 要 I
Abstract II
引 言 1
第一章 低剂量CT筛查的理论基础 2
1.1 肺癌早期筛查的重要性 2
1.2 低剂量 2
1.3 传统筛查方法对比分析 3
第二章 低剂量CT筛查的应用现状 4
2.1 国内外应用概况 4
2.2 筛查人群选择标准 4
2.3 实施流程与规范 5
第三章 低剂量CT筛查的效果评估 6
3.1 检出率与准确性分析 6
3.2 假阳性与假阴性评价 6
3.3 对早期肺癌诊断的影响 7
第四章 低剂量CT筛查的社会效益 8
4.1 成本效益分析 8
4.2 患者接受度调查 8
4.3 对公共健康的贡献 9
结 论 11
参考文献 12
致 谢 13
