Relevant Risk Factor and Follow-Up of Lung Nodules in Physical Examination with Low-Dose CT Screening
-
Shucai Wang
,
Fang Xu
,
Yanfang Wang
,
Han Wen
,
Mo Wang
,
Caixin Yuan
,
Xiaoli Xu
,
Yaqiang Du
Abstract
Background: We aimed to explore the risk factors of lung nodules and lung cancer in physical examination population with low-dose multi-slice spiral CT (LDCT) screening, to provide basis for lung cancer screening and follow-up management after CT examination.Methods: The general data, serum tumor markers and CT images of 2,274 patients underwent LDCT in the Physical Examination Center of the Fourth Hospital of Hebei Medical University, China in 2019 were retrospectively analyzed and followed up for three years.
Results: The detection rate of lung nodules was 48.42%. The detection rate of lung nodules was higher in females, those over 70, those with history of smoking, passive smoking, drinking, precious history of lung diseases and family history of malignant tumors, with statistically significant differences (P<0.05). The abnormal rate of serum tumor markers (CA199, CA125 female and CYFRA211) were higher than that in the non-nodule group, with statistically significant differences (P<0.05). Multivariate logistic regression analysis showed that gender, age, history of smoking, passive smoking, family history of malignant tumors and serum tumor markers (CYFRA211 and CA199) were independent risk factors for the occurrence of lung nodules.
Conclusion: Gender female, age>35, history of smoking, passive smoking, history of drinking, history of past lung disease, family history of malignant tumors, abnormal CYFRA211 tumor markers were detected and low dose multi-slice spiral CT image showed ground-glass nodules are risk factors for lung nodules and lung cancer, which should be paid close attention to during physical examination and follow-up.
1. Wang N, Liu S, Yang L, et al (2019). Inter-pretation of the 2018 Global Cancer Sta-tistical Report. Electronic Journal of Compre-hensive Cancer Therapy, 5(1): 87-97.
2. Dong H, Gao C, Ma X (2017). Analysis of the incidence and mortality of malignant tumors in Shijiazhuang City, Hebei Prov-ince in 2013. China Oncology, 26(06): 430-433.
3. Wood DE, Kazerooni E, Baum SL, Drans-field MT, et al (2015). Lung cancer screening, version 1.2015: featured up-dates to the NCCN guidelines. J Natl Compr Canc Netw, 13(1):23-34.
4. Wang L, Hong Q (2019). Interpretation of Chinese expert consensus on diagnosis and treatment of pulmonary nodules (2018 edition). Chinese Journal of Practical In-ternal Medicine, 39(5):440-442.
5. Wang HP, Wu HY, Wang Y, Wang L (2017). Combined detection of tumor markers and serum inflammatory factors in the diagnosis and treatment of gynecologic oncology. J Biol Regul Homeost Agents, 31(3):691-5.
6. Zhang C, Zheng W, Lv Y, Shan L, et al (2020). Postoperative carcinoembryonic antigen (CEA) levels predict outcomes af-ter resection of colorectal cancer in pa-tients with normal preoperative CEA lev-els. Transl Cancer Res, 9(1):111-8.
7. Sasamoto N, Babic A, Rosner BA, et al (2019). Development and validation of circulating CA125 prediction models in postmenopausal women. J Ovarian Res, 12(1):116.
8. Guo B, Lian W, Liu S, Cao Y, Liu J (2019). Comparison of diagnostic values be-tween CA125 combined with CA199 and ultrasound combined with CT in ovarian cancer. Oncol Lett, 17(6):5523-8.
9. Xu C, Liu J, Xing L, Liu S (2010). [Clinical significance of serum cytokeratin 19 fragment in the prediction of chemother-apy efficacy and prognosis in patients with advanced non-small cell lung can-cer]. Zhongguo Fei Ai Za Zhi, 13(10):954-61.
10. Zhao B, Zhang M, Liang Y, Yang Z (2019). An abnormal elevation of serum CA72-4 rather than other tumor markers can be caused by use of colchicine. Int J Biol Markers, 34(3):318-21.
11. Liu P, Zhu Y, Liu L (2015). Elevated serum CA72-4 levels predict poor prognosis in pancreatic adenocarcinoma after intensi-ty-modulated radiation therapy. Oncotarget, 6(11):9592-9.
12. Becker N, Motsch E, Trotter A, et al (2020). Lung cancer mortality reduction by LDCT screening-Results from the ran-domized German LUSI trial. Int J Cancer, 146(6):1503-1513.
13. Wang J, Liang D, Jin J, et al (2020). Screen-ing of lung cancer and pulmonary nod-ules with positive low-dose spiral CT in physical examination in Hebei Province. Chinese Public Health, 36(1):20-24.
14. Carlos RC, Sicks JD, Chiles C, et al (2019). Lung Cancer Screening in the National Cancer Institute Community Oncology Research Program: Availability and Ser-vice Organization. J Am Coll Radiol, 16(4 Pt A):427-434.
15. Heuvelmans MA, Groen HJ, Oudkerk M (2017). Early lung cancer detection by low-dose CT screening: therapeutic im-plications. Expert Rev Respir Med, 11(2):89-100.
16. Chen NA, Ma J (2014). A multivariate risk factors analysis study comtributing to so Iitary Pulmonary nodules. Chin J Clinicians, 8(14):2602-2607.
17. Shi J, Liang D, Li D, et al (2018). Analysis of the incidence and mortality of malignant tumors in Hebei Province in 2014. Oncolo-gy, 38(4):329-338.
18. Wang S, Tu J, Chen W (2019). Development and Validation of a Prediction Pneumo-thorax Model in CT-Guided Transtho-racic Needle Biopsy for Solitary Pulmo-nary Nodule. Biomed Res Int, 2019:7857310.
19. Gould NS, Min E, Huang J, et al (2015). Glutathione Depletion Accelerates Ciga-rette Smoke-Induced Inflammation and Airspace Enlargement. Toxicol Sci, 147(2):466-474.
20. Kurahashi N, Inoue M, Liu Y, et al (2008). Passive smoking and lung cancer in Jap-anese non-smoking women: a prospec-tive study. Int J Cancer, 122(3):653-657.
21. Pallis AG, Syrigos KN (2013). Lung cancer in never smokers: disease characteristics and risk factors. Crit Rev Oncol Hematol, 88(3):494-503.
22. Lin H, Huang YS, Yan HH, et al (2015). A family history of cancer and lung cancer risk in never-smoking: a clinic based case control study. Lung Cancer, 89(2):94-98.
23. Huang WY, Kemp TJ, Pfeiffer RM, et al (2017). Impact of freeze-thaw cycles on circulating inflammation marker meas-urements. Cytokine, 95:113-117.
24. Grunnet M, Sorensen JB (2012). Carci-noembryonic antigen (CEA) as tumor marker in lung cancer. Lung Cancer, 76(2):138-143.
25. Liu B (2019). Diagnosis and Treatment of Pulmonary Ground-glass Nodules. Zhongguo Fei Ai Za Zhi, 22(7):449-456.
26. Li Q, Fan L, Cao ET, Li QC, Gu YF, Liu SY (2017). Quantitative CT analysis of pulmonary pure ground-glass nodule predicts histological invasiveness. Eur J Radiol, 89:67-71.
27. Naidich DP, Bankier AA, MacMahon H, et al (2013). Recommendations for the management of subsolid pulmonary nodules detected at CT: a statement from the Fleischner Society. Radiology, 266(1):304-317.
2. Dong H, Gao C, Ma X (2017). Analysis of the incidence and mortality of malignant tumors in Shijiazhuang City, Hebei Prov-ince in 2013. China Oncology, 26(06): 430-433.
3. Wood DE, Kazerooni E, Baum SL, Drans-field MT, et al (2015). Lung cancer screening, version 1.2015: featured up-dates to the NCCN guidelines. J Natl Compr Canc Netw, 13(1):23-34.
4. Wang L, Hong Q (2019). Interpretation of Chinese expert consensus on diagnosis and treatment of pulmonary nodules (2018 edition). Chinese Journal of Practical In-ternal Medicine, 39(5):440-442.
5. Wang HP, Wu HY, Wang Y, Wang L (2017). Combined detection of tumor markers and serum inflammatory factors in the diagnosis and treatment of gynecologic oncology. J Biol Regul Homeost Agents, 31(3):691-5.
6. Zhang C, Zheng W, Lv Y, Shan L, et al (2020). Postoperative carcinoembryonic antigen (CEA) levels predict outcomes af-ter resection of colorectal cancer in pa-tients with normal preoperative CEA lev-els. Transl Cancer Res, 9(1):111-8.
7. Sasamoto N, Babic A, Rosner BA, et al (2019). Development and validation of circulating CA125 prediction models in postmenopausal women. J Ovarian Res, 12(1):116.
8. Guo B, Lian W, Liu S, Cao Y, Liu J (2019). Comparison of diagnostic values be-tween CA125 combined with CA199 and ultrasound combined with CT in ovarian cancer. Oncol Lett, 17(6):5523-8.
9. Xu C, Liu J, Xing L, Liu S (2010). [Clinical significance of serum cytokeratin 19 fragment in the prediction of chemother-apy efficacy and prognosis in patients with advanced non-small cell lung can-cer]. Zhongguo Fei Ai Za Zhi, 13(10):954-61.
10. Zhao B, Zhang M, Liang Y, Yang Z (2019). An abnormal elevation of serum CA72-4 rather than other tumor markers can be caused by use of colchicine. Int J Biol Markers, 34(3):318-21.
11. Liu P, Zhu Y, Liu L (2015). Elevated serum CA72-4 levels predict poor prognosis in pancreatic adenocarcinoma after intensi-ty-modulated radiation therapy. Oncotarget, 6(11):9592-9.
12. Becker N, Motsch E, Trotter A, et al (2020). Lung cancer mortality reduction by LDCT screening-Results from the ran-domized German LUSI trial. Int J Cancer, 146(6):1503-1513.
13. Wang J, Liang D, Jin J, et al (2020). Screen-ing of lung cancer and pulmonary nod-ules with positive low-dose spiral CT in physical examination in Hebei Province. Chinese Public Health, 36(1):20-24.
14. Carlos RC, Sicks JD, Chiles C, et al (2019). Lung Cancer Screening in the National Cancer Institute Community Oncology Research Program: Availability and Ser-vice Organization. J Am Coll Radiol, 16(4 Pt A):427-434.
15. Heuvelmans MA, Groen HJ, Oudkerk M (2017). Early lung cancer detection by low-dose CT screening: therapeutic im-plications. Expert Rev Respir Med, 11(2):89-100.
16. Chen NA, Ma J (2014). A multivariate risk factors analysis study comtributing to so Iitary Pulmonary nodules. Chin J Clinicians, 8(14):2602-2607.
17. Shi J, Liang D, Li D, et al (2018). Analysis of the incidence and mortality of malignant tumors in Hebei Province in 2014. Oncolo-gy, 38(4):329-338.
18. Wang S, Tu J, Chen W (2019). Development and Validation of a Prediction Pneumo-thorax Model in CT-Guided Transtho-racic Needle Biopsy for Solitary Pulmo-nary Nodule. Biomed Res Int, 2019:7857310.
19. Gould NS, Min E, Huang J, et al (2015). Glutathione Depletion Accelerates Ciga-rette Smoke-Induced Inflammation and Airspace Enlargement. Toxicol Sci, 147(2):466-474.
20. Kurahashi N, Inoue M, Liu Y, et al (2008). Passive smoking and lung cancer in Jap-anese non-smoking women: a prospec-tive study. Int J Cancer, 122(3):653-657.
21. Pallis AG, Syrigos KN (2013). Lung cancer in never smokers: disease characteristics and risk factors. Crit Rev Oncol Hematol, 88(3):494-503.
22. Lin H, Huang YS, Yan HH, et al (2015). A family history of cancer and lung cancer risk in never-smoking: a clinic based case control study. Lung Cancer, 89(2):94-98.
23. Huang WY, Kemp TJ, Pfeiffer RM, et al (2017). Impact of freeze-thaw cycles on circulating inflammation marker meas-urements. Cytokine, 95:113-117.
24. Grunnet M, Sorensen JB (2012). Carci-noembryonic antigen (CEA) as tumor marker in lung cancer. Lung Cancer, 76(2):138-143.
25. Liu B (2019). Diagnosis and Treatment of Pulmonary Ground-glass Nodules. Zhongguo Fei Ai Za Zhi, 22(7):449-456.
26. Li Q, Fan L, Cao ET, Li QC, Gu YF, Liu SY (2017). Quantitative CT analysis of pulmonary pure ground-glass nodule predicts histological invasiveness. Eur J Radiol, 89:67-71.
27. Naidich DP, Bankier AA, MacMahon H, et al (2013). Recommendations for the management of subsolid pulmonary nodules detected at CT: a statement from the Fleischner Society. Radiology, 266(1):304-317.
| Files | ||
| Issue | Vol 52 No 2 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i2.11888 | |
| Keywords | ||
| Lung nodules Lung cancer Risk factors Follow-up | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Wang S, Xu F, Wang Y, Wen H, Wang M, Yuan C, Xu X, Du Y. Relevant Risk Factor and Follow-Up of Lung Nodules in Physical Examination with Low-Dose CT Screening. Iran J Public Health. 2023;52(2):.350-359.
