Background: Low-dose computed tomography (LDCT) has been widely adopted for lung cancer screening due to its proven ability to reduce lung cancer mortality, especially among high-risk populations. Methods: This retrospective study aims to evaluate the impact of LDCT screening on non-small cell lung cancer (NSCLC) staging at Kaohsiung Medical University Hospital (KMUH) from 2011 to 2020, following the introduction of LDCT in 2013. The study examines the correlation between LDCT screening volume and changes in the distribution of NSCLC stages, particularly early-stage (stages 0 and I) and late-stage (stage IV) diagnoses. Additionally, it explores the differences in histopathological subtypes, focusing on adenocarcinoma and squamous cell carcinoma, and assesses the impact of early detection on five-year survival rates. Results: The results show a significant increase in early-stage NSCLC diagnoses, particularly in adenocarcinoma cases, where early-stage diagnoses rose from 10.4% in 2010 to 38.7% in 2019. However, the number of stage IV cases remained stable, indicating that LDCT may not substantially reduce late-stage diagnoses. Pearson’s correlation analysis demonstrated a strong positive correlation between LDCT screening and early-stage NSCLC detection, particularly for adenocarcinoma (p< 0.001), though the early detection of squamous cell carcinoma and small cell carcinoma remained limited. Conclusions: The study concludes that LDCT screening plays a crucial role in improving early NSCLC detection and five-year survival rates. Future research should focus on optimizing screening strategies to capture more at-risk populations and enhance the detection of harder-to-diagnose subtypes like squamous cell carcinoma.
背景：低剂量计算机断层扫描（LDCT）因其已被证实能降低肺癌死亡率，尤其是在高危人群中，已被广泛用于肺癌筛查。方法：本研究为回顾性分析，旨在评估自2013年引入LDCT后，高雄医学大学附属医院（KMUH）在2011年至2020年间LDCT筛查对非小细胞肺癌（NSCLC）分期的影响。研究探讨了LDCT筛查量与NSCLC分期分布变化之间的相关性，特别是早期（0期和I期）与晚期（IV期）诊断的变化。此外，研究还分析了组织病理学亚型的差异，重点关注腺癌和鳞状细胞癌，并评估了早期检测对五年生存率的影响。结果：结果显示，早期NSCLC诊断显著增加，尤其是在腺癌病例中，早期诊断比例从2010年的10.4%上升至2019年的38.7%。然而，IV期病例数量保持稳定，表明LDCT可能并未显著减少晚期诊断。皮尔逊相关性分析显示，LDCT筛查与早期NSCLC检测呈强正相关，尤其是腺癌（p<0.001），但鳞状细胞癌和小细胞癌的早期检测仍有限。结论：研究认为，LDCT筛查在提高NSCLC早期检测率和五年生存率方面发挥了关键作用。未来研究应侧重于优化筛查策略，以覆盖更多高危人群，并提升对鳞状细胞癌等较难诊断亚型的检测能力。
肿瘤(癌症)患者之家