目的通过对相关文献的荟萃分析,评价低剂量螺旋CT(LDCT)在高危人群早期肺癌筛查中的作用。方法利用关键词在PubMed、EBSCO、Cochrane等数据库中进行文献查找,根据制定的纳入标准和排除标准对文献进行筛选,最后纳入数据,利用统计软件进行数据分析并得出统计结果。结果纳入10个随机对照研究的数据。与胸部X线(CXR)检查及无检查的对照组相比,LDCT组的肺癌检出率较对照组的优势比(OR)为3.705(95%CI3.527~3.891)。亚组分析中,LDCT对Ⅰ期肺癌的检测较对照组高了4.464倍(95%CI2.860~6.969),腺癌的检出率在LDCT组比对照组高了4.652倍(95%CI2.877—7.522)。结论LDCT对肺癌尤其是Ⅰ期肺癌、腺癌具有较高的检出率。
Objective To explore the values of low-dose computed tomography (LDCT) in the screening of high-risk populations for early lung cancer through a meta-analysis of the relevant literature. Methods PubMed, EBSCO, Cochrane and other databases were searched with key words. And the studies were selected by the inclusion and exclusion criteria. The baseline data were collected and analyzed by statistical software. Resnlts Ten random controlled trials (RCTs) were selected. Compared to the chest X ray (CXR) screening and no screening controls, LDCT screening had an odds ratio (OR) of 3. 705,95% CI 3. 527 -3. 891. And in the subgroup analysis, a higher number of stage Ⅰ lung cancer was detected (OR 4. 464, 95% CI 2. 860 -6. 969) by LDCT. Moreover, LDCT screening showed an increased detection of adenocarcinoma in lung cancer ( OR 4. 652, 95% CI 2. 877 - 7. 522 ). Conclusion LDCT is superior to CXR in the early detection of lung cancer, especially stage Ⅰ and adenocarcinoma.