与第一次筛查相比，重复肺癌筛查显示较少的不同变异的CXR异常

IF 1.6 4区医学 Q3 PRIMARY HEALTH CARE

Primary Health Care Research and Development Pub Date : 2021-01-01 DOI:10.15761/hpc.1000210

Tatsuo Kimura, S. Fukumoto, Akemi Nakano, H. Fujii, Yuji Nadatani, Yukie Tauchi, Shingo Takashima, Yuko Nishii, K. Otani, Naomi Ageshio, T. Suzumura, N. Kawada

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引用次数: 0

摘要

目的:胸部x线摄影(CXR)是检测肺癌最常用的筛查方法。对比CXR检查可以帮助发现新的阴影。在与健康检查相同的设施中接受重复检查的参与者(pts)可以接受CXR的比较审查。据推测，在筛查中，与先前的CXR相比，CXR异常的诊断可能会有所不同。方法:我们回顾性分析了MedCity21正在进行的健康检查登记的一年队列。对在x光透视中有异常需要药物治疗的患者，请其到我诊所进行胸部计算机断层扫描。我们使用卡方检验比较了重复就诊患者和首次就诊患者之间的各种CXR异常。结果:共有7872 / 5818(57.5 / 42.5%)名患者进行了13,690次重复/首次访问。接受胸部CT的143 / 191例患者中有324例和108 / 126例患者中有234例出现CXR异常。与首次就诊的患者相比，重复就诊的患者在CXR中需要药物治疗的异常比例明显低于首次就诊的患者(p < 0.01)。CT确认显示，与首次就诊患者相比，重复患者的CXR异常诊断有不同的变化。与首次就诊患者相比，复诊患者出现旧发炎性改变的比例显著降低(p=0.02)，出现急性炎性阴影的比例显著升高(p=0.02)。结论:经CT立即确认，重复患者的CXR异常诊断与首次患者相比有不同的差异。对以往的x光检查进行比较可能对排除肺癌非常有效。*通讯对象:大阪市大学医学研究生院高级预防医学科木村达夫博士，日本大阪市安倍区安倍府路1-143安倍府21F, 545-6090，电话:81-6-6624-4041;传真:81-6-6624-8212;电子邮件:kimutats@med.osaka-cu.ac.jp

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Repeat lung cancer screenings reveal less CXR abnormalities with different variations than first-time screening

Objectives: Chest radiography (CXR) is the most common screening procedure for the detection of lung cancer. A comparative CXR review can help to detect new shadows. Participants (pts) who undergo repeated screening at the same facility as the health check-up can receive a comparative review of the CXR. It has been hypothesized that the diagnosis of CXR abnormalities in screening would be different when compared to previous CXR and when not. Methods: We retrospectively analyzed one-year cohort derived from the ongoing MedCity21 health check-up registry. The pts with abnormalities requiring medication in CXR were invited to our clinic for chest computed tomography (CT). We compared the varieties of abnormalities on CXR between repeated and first-visit pts using chi-square tests. Results: A total of 13,690 repeated / first visits of 7872 / 5818 (57.5 / 42.5%) pts were enrolled. The CXR abnormalities included 324 of 143 / 191 pts and 234 of 108 / 126 pts who underwent chest CT, respectively. Repeated pts had a significantly lower proportion of abnormalities in CXR that required medication than the first-visit pts (p < 0.01). CT confirmation revealed that CXR abnormalities in repeated pts were diagnosed with different variations compared to those of first-visit pts. Repeated pts had a significantly lower proportion of old inflammatory changes (p=0.02) and a higher proportion of acute inflammatory shadow (p=0.02) than first-visit pts. Conclusions: Immediate confirmation by CT revealed that CXR abnormalities in repeated pts were diagnosed with different variations compared to those of firsttime pts. A comparative review of previous CXR may be highly effective in ruling out lung cancer. *Correspondence to: Tatsuo Kimura, M.D. Ph.D., Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka City University, 1-143 AbenoHARUKAS 21F, Abenosuji, Abeno-ku Osaka 545-6090, Japan, Tel: 81-6-6624-4041; Fax: 81-6-6624-8212; E-mail: kimutats@med.osaka-cu.ac.jp

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来源期刊

Primary Health Care Research and Development PRIMARY HEALTH CARE-

CiteScore

2.60

自引率

6.20%

发文量

119

审稿时长

33 weeks

期刊介绍： Primary Health Care Research & Development is aimed specifically at both researchers and practitioners in primary health care, bridging the gap between the two areas. It provides a forum for the publication of international, interdisciplinary research and development in primary health care. It is essential reading for all involved in primary care: nurse practitioners, GPs and health service managers; professional and local groups in community health; researchers and academics; purchasers of primary health care services; allied health practitioners in secondary services and health-related consumer groups.