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低剂量CT检查20年以上工龄煤矿工人肺结节的意义 被引量:3

Clinical significance of low-dose CT performed for three consecutive years in diagnosis of lung nodules in coal mine workers with 20 working years
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摘要 目的探讨应用低剂量CT(LDCT)对较长工龄煤矿职工检查的意义。方法907例工龄超过20年煤矿职工,男863例,女44例,平均年龄49.5岁,2013年对每例行DR体检,2014至2016连续3年对每例行LDCT体检。结果2013年DR提示肺内结节32例。2014年LDCT:肺内非钙化结节269例,与前一年度DR检出例数比较,差异有统计学意义(χ2=-233.73,P〈0.01)。不同接尘工龄受检者结节检出率的差异有统计学意义(χ2=6.648,P=0.00)。男性结节检出率明显高于女性,差异有统计学意义(χ2=5.690,P=-0.017)。不同工种的结节个数的差异无统计学意义(χ2=16.985,P=0.05)。结节总数443个,实性结节占71.56%,≤4mm的结节占55.75%;基线LDCT后经手术证实恶性0.66%(6/907)。2015、2016年复查LDCT:新发结节8例,增大结节3例,≤4mm的结节均无明显变化。结论用LDCT对煤矿职工高危人群筛查十分必要。≤4mm结节随诊策略与阴性一样,〉4mm~8mm结节行年度复查,〉8mm结节转入临床处理。 Objective To investigate the clinical significance of low-dose CT(LDCT) in coal mine workers with relatively long working years. Methods A total of 907 coal mine workers with ≥20 working years were enrolled, among whom there were 863 male and 44 female workers with a mean age of 49.5 years. Digital radiography (DR) was performed for these workers in 2013, and LDCT was performed for three consecutive years from 2014 to 2016. Results A total of 32 workers were found to have lung nodules by DR in 2013, while in 2014, 269 workers were found to have non-calcified lung nodules by LDCT, and there was a significant difference in the number of workers with lung nodules (≥2=233.73, P〈0.005 ). There was also a significant difference in the detection rate of nodules between the workers with different working years of dust exposure (χ2=6.648, P=0.00). The male workers had a significantly higher detection rate of nodules than the female workers (χ2=5.690, P=0.017). There was no significant difference in the number of nodules between workers with different types of work (χ2=16.985, P= 0.05). There were 443 lung nodules in total, among which 71.56% were solid nodules and 55.75% had a size of ≤ 4 mm; malignant nodules were confirmed by surgery in 6 (0.66%) of the 907 workers after baseline LDCT. LDCT reexamination in 2015 and 2016 found new nodules in 8 workers and enlarged nodules in 3 workers, and there was no significant change in the number of nodules with a size of ≤4 mm. Conclusions It is necessary to perform high-risk population screening for coal mine workers by LDCT. The follow-up strategies for nodules with a size of ≤4 mm are the same as those for negative results ; annual reexamination is recommended for nodules with a size of 〉 4-8 mm, and clinical treatment should be considered for nodules with a size of〉8 mm.
作者 李建钢 陈新晖 葛昊 秦霞 景小刚 王桂芝 毛东伟 庄广义 赵宝琼 LI Jiangang, Chen Xinhui, Ge Hao, Qin Xia, Jing Xiaogang, Wang Guzhi, Mao Dongwei, Zhuang Guangyi, Zhao Baoqiong.( Department of Radiology, China Ping Mei Shen Ma Medical Group General Hospital, Pingdingshan, Henan Province 467000, China)
出处 《中华劳动卫生职业病杂志》 CAS CSCD 2017年第9期679-682,共4页 Chinese Journal of Industrial Hygiene and Occupational Diseases
基金 中平能化集团重点科技开发基金项目(41040320091108)
关键词 低剂量CT 多项筛查 肺结节 孤立性 Low-dose CT Multiphastic screening Pulmonary nodule, solitary
作者简介 通信作者:陈新晖,E-mail:ljig998@126.com
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