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Clinical characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer hospital

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Cancer Biology & Medicine 2020年第1期17卷 199-207页

作者： Xiaonan Cui Daiwei Han Marjolein AHeuvelmans Yihui Du Yingru Zhao Lei Zhang Harry JMGroen geertruida hde bock Monique DDorrius Matthijs Oudkerk Rozemarijn Vliegenthart Zhaoxiang Ye Department of Radiology Tianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjinTianjin's Clinical Research Center for CancerTianjin 300060China Department of Radiology University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands Department of Epidemiology University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands Medisch Spectrum Twente Department of PulmonologyEnschede 7512 KZThe Netherlands Department of Thoracic Surgery Tianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjinTianjin’s Clinical Research Center for CancerTianjin 300060China Department of Pulmonary Diseases University of GroningenUniversity Medical Center GroningenGroningen 9713 GZThe Netherlands University of Groningen University Medical Center GroningenGroningen 9713 GZThe Netherlands

Objectives:To evaluate the characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer ***:Patients with pulmonary nodules 4–25 mm in diameter detected via computed tomography(CT)in 2013 were consecutively *** analysis was restricted to patients with a histological nodule diagnosis or a 2-year follow-up period without nodule growth confirming benign *** information was collected from hospital ***:Among the 314 nodules examined in 299 patients,212(67.5%)nodules in 206(68.9%)patients were *** to benign nodules,malignant nodules were larger(18.0 mm vs.12.5 mm,P<0.001),more often partly solid(16.0%vs.4.7%,P<0.001)and more often spiculated(72.2%vs.41.2%,P<0.001),with higher density in contrast-enhanced CT(67.0 HU vs.57.5 HU,P=0.015).Final diagnosis was based on surgery in 232 out of 314(73.9%)nodules,166 of which were identified as malignant[30(18.1%)stage III or IV]and 66 as *** 36 nodules(11.5%),diagnosis was confirmed by biopsy and the remainder verified based on stability of nodule size at follow-up imaging(n=46,14.6%).Among 65 nodules subjected to gene(EGFR)mutation analyses,28(43.1%)cases(EGFR19 n=13;EGFR21 n=15)were identified as EGFR mutant and 37(56.9%)as EGFR *** to surgery,the majority of patients[n=194(83.6%)]received a contrast-enhanced CT scan for staging of both malignant[n=140(84.3%)]and benign[n=54(81.8%)]*** of positron emission tomography(PET)-CT was relatively uncommon[n=38(16.4%)].Conclusions:CT-derived nodule assessment assists in diagnosis of small to intermediate-sized malignant pulmonary ***,contrast-enhanced CT is commonly used as the sole diagnostic confirmation technique for pre-surgical staging,often resulting in surgery for late-stage disease and unnecessary surgery in cases of benign nodules.

关键词： Lung nodule diagnosis computed tomography pathology China

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Methods of computed tomography screening and management of lung cancer in Tianjin: design of a population-based cohort study

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Cancer Biology & Medicine 2019年第1期16卷 181-188页

作者： Yihui Du Yingru Zhao Grigory Sidorenkov geertruida H.de bock Xiaonan Cui Yubei Huang Monique D.Dorrius Mieneke Rook Harry J.M.Groen Marjolein A.Heuvelmans Rozemarijn Vliegenthart Kexin Chen Xueqian Xie Shiyuan Liu Matthijs Oudkerk Zhaoxiang Ye Department of Epidemiology University of Groningen University Medical Center Groningen Center for Medical Imaging-North East Netherlands University of Groningen University Medical Center Groningen Department of Radiology Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin Tianjin’s Clinical Research Center for Cancer Department of Epidemiology and Biostatistics Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for Cancer Key Laboratory of Cancer Prevention and Therapy Tianjin Tianjin’s Clinical Research Center for Cancer Department of Radiology University of Groningen University Medical Center Groningen Department of Radiology Martini Hospital Department of Pulmonary Diseases University of Groningen University Medical Centre Groningen Medisch Spectrum Twente Department of Pulmonology Department of Radiology Shanghai General HospitalShanghai Jiao Tong University School of Medicine Department of Radiology Shanghai Changzheng Hospital The Second Military Medical University Shanghai

Objective: European lung cancer screening studies using computed tomography(CT) have shown that a management protocol based on measuring lung nodule volume and volume doubling time(VDT) is more specific for early lung cancer detection than a diameter-based protocol. However, whether this also applies to a Chinese population is unclear. The aim of this study is to compare the diagnostic performance of a volume-based protocol with a diameter-based protocol for lung cancer detection and optimize the nodule management criteria for a Chinese ***: This study has a population-based, prospective cohort design and includes 4000 participants from the Hexi district of Tianjin, China. Participants will undergo low-dose chest CT at baseline and after 1 year. Initially, detected lung nodules will be evaluated for diameter and managed according to a routine diameter-based protocol(Clinical Practice Guideline in Oncology for Lung Cancer Screening, Version 2.2018). Subsequently, lung nodules will be evaluated for volume and management will be simulated according to a volume-based protocol and VDT(a European lung nodule management protocol). Participants will be followed up for 4 years to evaluate lung cancer incidence and mortality. The primary outcome is the diagnostic performance of the European volume-based protocol compared to diameter-based management regarding lung nodules detected using low-dose ***: The diagnostic performance of volume-and diameter-based management for lung nodules in a Chinese population will be estimated and ***: Through the study, we expect to improve the management of lung nodules and early detection of lung cancer in Chinese populations.

关键词： Lung cancer lung nodules screening computed tomography China

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