Background: Lung cancer incidence in Macao increases gradually, smoking is one of the important high risk factors. The purpose of this study is to observe the detection rate of lung cancer and nodules in long-term smoking Macao individuals.
Methods: We recruited eligible Macao residents by publicity, all subjects were arranged to receive low-dose computed tomography screening. Image features of lung nodules were analyzed by radiologist. For suspicious lung cancer, multiple disciplinary team (MDT) was arranged.
Results: A total of 291 were adopted, 10 lung cancers were detected, the detection rate of lung cancer was 3.44% (95%CI: 2.78%-4.01%), all were males. There were 5 adenocarcinoma patients, each 2 squamous-cell carcinoma and small cell lung carcinoma patients; 1 adenosquamous cancer patient. Among 10 lung cancers, 40% had stage 1 disease. The detection rate of lung nodules was 72.9% (95%CI: 67.8%-78.0%); The number of suspicious lung nodules were 44, and the detection rate was 15.1% (95%CI: 11.0%-19.2%). There was no significant differences in the lung cancer detection rate between the single and multiple lung nodule groups (P>0.05). There were 168 subjects in the <6 mm solid lung nodule (SN) and <5 mm no-solid lung nodule (NSN) group and no lung cancer was found, 44 subjects in the ≥6 mm SN and ≥5 mm NSN group. All 9 lung cancer patients were detected in this group. The detection rate of lung cancer was higher than that of the <6 mm SN and <5 mm NSN group (P<0.05).
Conclusions: There are high detection rate of lung cancer and lung nodule in the long-term smoking individuals. The lung cancer rate increases when the lung nodule size is larger than 6 mm in SN and 5 mm in NSN. Adenocarcinoma is the major type in the smokers' lung cancers. We suggest long-term smokers should join in the future lung cancer screening trial in Macao. Female lung cancer screening should be established different standard.
【中文题目：在中国澳门吸烟人群中的肺癌筛查研究】 【中文摘要：背景与目的 中国澳门肺癌发病率逐年上升，吸烟人群是肺癌的高发人群，本研究旨在了解中国澳门长期吸烟人群的肺癌发病情况及胸部低剂量计算机断层扫描（low-dose computed tomography, LDCT）肺结节特点。方法 通过澳门中华医学会会员私家医生推荐及宣传招募中国澳门无症状长期吸烟人士，行胸部LDCT检查，分析肺癌、肺部结节检出率及影像学特点。结果 符合纳入条件者291例，检出肺癌10例，检出率3.44%（95%CI: 2.78%-4.01%），其中，肺腺癌5例，鳞癌、小细胞肺癌各2例，腺鳞癌1例。早期肺癌4例，占40%。212例检出肺结节，肺结节总检出率72.9%（95%CI: 67.8%-78.0%）；疑似肺癌结节44例，检出率15.1%（95%CI: 11.0%-19.2%）。单发结节51例，无肺癌检出；多发结节161例，检出肺癌9例，两组肺癌检出率无统计学差异（P>0.05）。<6 mm实性结节与<5 mm非实性结节组168例，未检出肺癌；≥6 mm实性结节与≥5 mm非实性结节组44例，检出肺癌9例，两组比较有统计学差异（P<0.05）。结论 长期吸烟人群中肺癌检出率高，类型以腺癌为主，肺部结节发生率高，当实性结节≥6 mm或非实性结节≥5 mm时，肺癌检出率增高。建议在符合高危因素的男性吸烟人群中推行胸部LDCT筛查肺癌，女性肺癌筛查，应重新界定高危因素。 】 【中文关键词：肺肿瘤；筛查；早期诊断】.
Keywords: Early diagnosis; Lung neoplasms; Screening.