肺癌怎么筛查？英文双语对照

现在的人们越来越重视自身的健康，大部分人都可以做到一年进行一次健康体检。但是关于肺癌的筛查很多人有一个误区，他们仍然像过去一样做着胸片或者胸透，而今天我要告诉大家的是肺癌的筛查一定选择低剂量螺旋CT扫描。

什么是低剂量螺旋CT扫描？

低剂量CT（即LDCT）就是在传统CT检查的基础上降低射线剂量，一次LDCT的射线剂量相当于常规CT的1/5到1/10左右。这个辐射量也就相当于100天周围环境的自然辐射量，比做一次七八个小时的长途飞机接受的辐射量还要小，这对人体的损伤几乎可以忽略不计。

因为肺内气体多，当降低射线剂量后并不影响检查结果的准确性，所以低剂量在辐射剂量降低的基础上仍然保证了分辨率和灵敏度，甚至能够发现直径＜5mm的微小病灶。

为什么肺癌的筛查要选择低剂量螺旋CT？

很多人都问过我：“医生，为什么肺癌筛查要选择低剂量螺旋CT？以前各种体检套餐中关于肺部疾病的筛查都是胸片或胸部透视，是因为做CT医院的收入会高吗？”

之前筛查肺癌选择胸片或者胸透是因为受制于当时影像学检查技术。随着影像学检查技术的突飞猛进，低剂量螺旋CT检查已经替代了传统的胸透检查，而替代的原因正是因为低剂量螺旋CT可以发现以往无法早期获知的肺部结节。

以往的胸部X线片受制于机器分辨率低，很多小的肺结节不能及时发现，再加上早期肺癌并无明显症状，所以才有了很多人半年前查体正常，半年后发现肺癌晚期的悲剧。

美国国家肺癌筛查试验（NLST）对超过53000名重度吸烟者进行每年一次的CT和胸片检查，通过3年的对比，CT的敏感性和发现早期（ⅠA期）肺癌的病例数比胸片高出将近一倍，肺癌的死亡率减少了将近20%。

越来越多的单位体检已经选择了低剂量螺旋CT

从去年开始，我们医院职工健康查体由原来的胸片换成了低剂量螺旋CT，看似很简答的做法就挽救了医院20名员工的性命！

因为换了更先进的肺癌早筛检查方法，全院近2000职工检测出了20粒早期肺癌。因为筛查的早，很多肺癌只有不到1公分，虽然确诊了肺癌但是因为癌症未发生远处转移，手术切除后效果非常好，甚至可以说做了手术后就治愈了。但是如果没有更换筛查方法还是按照之前的胸片去筛查的话，很多人可能发现不了自己的肿瘤，当自己发现时很可能已经失去了手术的最佳时机。

哪些人群一定要定期筛查肺部CT？

低剂量螺旋CT可以发现胸片不能发现的早期肺癌，特别是肺癌的高危人群一定要定期筛查低剂量螺旋胸部CT，哪些人属于高危人群呢？具体如下：年龄≥40岁且具有以下任一危险因素者：

1.吸烟≥20包/年，或曾经吸烟≥20包/年，戒烟时间<15年；

2.有环境或高危职业暴露史（如石棉、铍、铀、氡等接触者）；

3.合并慢阻肺、弥漫性肺纤维化或既往有肺结核病史者；

4既往罹患恶性肿瘤或有肺癌家族史者。

总结：低剂量螺旋CT对于肺癌筛查的巨大益处是显而易见的，而它所带来的伤害是可以降低，且将持续降低。所以告诉您身边的朋友进行健康体检时一定选择低剂量螺旋胸部CT。

我是公立三级医院的胸心外科医生Lion，感谢阅读，如果赞同我的观点帮忙点个关注或者点个赞吧！

Present people takes the health of oneself seriously more and more, major person can accomplish a year to undertake healthy check-up. But check a lot of people to have an error about the sieve of lung cancer, they still are doing sternum like in the past or the bosom is appeared, and the sieve that what I should tell everybody today is lung cancer checks CT of helix of due option small dose to scan.

What is scanning of CT of small dose helix?

Small dose CT (namely LDCT) ray dosage is reduced on the foundation that checks in traditional CT namely, the ray dosage of LDCT is equivalent to the 1/5 of groovy CT be being controlled to 1/10. This radiate measures the natural radiate volume that also is equivalent to surroundings 100 days, the radiation amount that accepts than making the long-distance aircraft of 78 hours is even small, this is almost negligible to the injury of human body not plan.

Because the gas inside lung is much, do not affect the accuracy that checks a result after reducing ray dosage, so small dose still assured resolution and sensitivity on the base that radiation dosage reduces, can discover the tiny focus of a disease of diametical ＜ 5mm even.

Why is the sieve of lung cancer checked should choose CT of small dose helix?

A lot of people had asked me: "Doctor, why is lung cancer sieve checked should choose CT of small dose helix? Be being checked about the sieve of lung disease in all sorts of check-up formulas before is sternum or bosom fluoroscopy, be because make the income of CT hospital,is the meeting tall? Be because make the income of CT hospital,is the meeting tall??

The sieve checks lung cancer to choose sternum before or because be enslaved to be enslaved to is video at that time,the bosom is fully learn to check a technology. As video the advance rapidly that learns to check a technology, examination of CT of small dose helix had replaced traditional bosom to appear an examination, and the reason that replace can discover because of CT of small dose helix just about before cannot inchoate learned lung is nodal.

Before bosom X line piece resolution of machine of be enslaved to be enslaved to is low, a lot of small lung tubercle cannot discover in time, do not have apparent symptom plus inchoate lung cancer, it is normal that before just having half an year of a lot of people so, system is examined, what discover lung cancer is terminal after half an year is tragic.

Sieve of American country lung cancer investigates a test (NLST) the person that spend smoking again to more than 53000 undertakes annual CT and sternum examination, pass contrast of 3 years, the sensitivity of CT and discovery are inchoate (Ⅰ A period) the case load of lung cancer compares sternum tower above near one times, the mortality of lung cancer decreased near 20% .

More and more unit check-up had chosen CT of small dose helix

Begin from last year, health of our hospital worker checked body to change CT of small dose helix by original sternum, look be like very brief answering practice saved a hospital the life of 20 employee!

Because changed more advanced lung cancer to sift examination method early, complete courtyard is close 2000 workers detect gave 20 inchoate lung cancer. What check because of the sieve is early, a lot of lung cancer are less than 1 centimeter only, although diagnose lung cancer but did not produce far to transfer because of cancer, the effect after the operation is excised is first-rate, can say to after becoming an operation, be cured even. But if if did not change to the sieve investigates a method or be sifted according to the sternum before,be being checked, a lot of people may not discover his tumour, had lost the optimal opportunity of the operation probably when he discovers.

What crowd must be sifted regularly check lung CT?

CT of small dose helix can discover the inchoate lung cancer that sternum cannot discover, especially the tall danger crowd of lung cancer must be sifted regularly check CT of bosom of small dose helix, what person belongs to tall danger crowd? Specific as follows: Age ≥ 40 years old and the person that have factor of risk of the following either:

1. smoking ≥ 20 packets / year, or once smoked ≥ 20 packets / year, <15 of time of smoke of Buddhist monastic discipline year;

2. has an environment or tall danger profession is exposed history (the person that wait for a contact like asbestine, Beryllium, uranous, radon) ;

3. is amalgamative slow block lung, diffuse to sexual lung fiber is changed or be gone to already the person that have phthisical medical history;

4 have malignant tumor toward meet with already or have lung cancer familial history person.

Summary: The huge profit that CT of small dose helix checks to lung cancer sieve is clearly, and the harm that it brings is to be able to be reduced, and will reduce continuously. CT of bosom of small dose helix chooses certainly when telling you the friend beside undertakes healthy check-up so.

I am public the pectoral heart of 3 class hospital surgical Lion, acknowledgment is read, if approve of my viewpoint helps nod an attention to perhaps nod an assist!