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目的低剂量胸部CT(LDCCT)评估肺肿瘤初步筛查高危人群中长期稳定的肺内非钙化小结节(<10mm)。方法初步连续LDCCT筛查超过2年的志愿者共有449例。确诊肺内非钙化结节(NCN)≥10mm的志愿者被推荐行常规的肺肿瘤后续检查。NCN<10mm的志愿者按照协议继续随访,对经过2年随访结节大小没有变化者,在7年随访后采用LDCCT重新评估为间断生长的结节。结果经过7年LDCCT随访,其中83例随访的志愿者肺内非钙化结节大小保持在10mm以内,78例NCN大小无变化,4例缩小。在7年随访中,只有1例志愿者肺内结节间断生长(从6mm到9mm),但其后2年随访中该结节大小无明显变化。结论经过2年LDCCT随访,其大小无变化或者缩小的肺内NCN(<10mm)很可能是良性的。要点①CT正在越来越多地用于筛选肺肿瘤,然而CT经常意外发现肺结节。②<10mm的肺内NCN随访时间7年是比较可靠的。③高危病人中最大的结节甚至也很可能是良性的。
Purpose Low-dose chest CT (LDCCT) assessment of lung cancer preliminary screening of long-term population of non-small pulmonary nodules in high-risk groups (<10mm). Methods A total of 449 volunteers who had initially undergone continuous LDCCT screening for more than 2 years were included. Volunteers diagnosed with non-calcified nodules (NCN) ≥10 mm in the lung are recommended for routine lung tumor follow-up. Volunteers with NCN <10 mm continued follow-up according to the protocol. Those with no change in nodules size at 2-year follow-up were reassessed as intermittent nodules using LDCCT after 7 years of follow-up. Results After seven years of follow-up of LDCCT, the size of non-calcified nodules in the lung tissue of 83 follow-up patients remained within 10mm. There was no change in the size of 78 NCNs and 4 cases were reduced. At 7 years of follow-up, only 1 volunteer developed intermittent pulmonary nodules (ranging from 6 mm to 9 mm), but there was no significant change in nodule size at 2 years of follow-up. Conclusion After 2 years of follow-up of LDCCT, NCN (<10 mm) in lung with no change in size or shrinkage is likely to be benign. Key points ①CT is increasingly being used to screen for lung tumors, however CT often unexpectedly detects pulmonary nodules. ② <10mm pulmonary NCN follow-up time of 7 years is more reliable. ③ The highest nodules in high-risk patients may even be benign.