Lung cancer risk based on visual assessment of emphysema and interstitial abnormalities in low dose chest CT
EUROPEAN RESPIRATORY JOURNAL(2014)
摘要
Introduction – Screening for lung cancer should be limited to a high risk population, and CT findings may be relevant for predicting the risk of lung cancer. Aims and objectives – To compare the occurrence of visually detected emphysema and interstitial abnormalities in subjects with and without lung cancer. Methods and materials – Baseline low dose CT scans of 1990 participants from The Danish Lung Cancer Screening Trial were evaluated. Participants had a smoking history of at least 20 pack years, a FEV 1 of at least 30% of predicted, and were aged 50-75 years. Two blinded observers independently scored emphysema and various interstitial abnormalities as present or absent, and furthermore the degree of emphysema was scored as 0: 0%, 1:1-5%, 2:6-25%, 3:26-50%, 4:51-75% or 5:76-100%. Furthermore, emphysema was measured quantitatively as: 15 th percentile density (PD15), low attenuation area percentages with a threshold of -910 Hounsfield Units (HU) (LAA%-910) and -950 HU (LAA%-950). Results - Visual evaluations: emphysema present: OR 1.9 (p= 0.009). Mean emphysema grade 1.4 (SD 0.6) versus 1.2 (SD 0.5), p=0.010 in groups with and without lung cancer, respectively. Interstitial abnormality present: OR 4.5 (p Conclusion – In a lung cancer screening cohort of current and former heavy smokers visual assessment of even early signs of emphysema and interstitial abnormalities can be used for predicting lung cancer as these findings are significantly overrepresented in lung cancer patients. Quantitative measurements of emphysema—regardless of type—did not have the same predictive value.
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关键词
lung cancer,emphysema,visual assessment,ct
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