TY - JOUR T1 - 低剂量胸部计算机断层摄影筛查和不吸烟者JF肺癌肺结节的侵入性诊断 - 欧洲呼吸杂志JO - 欧洲呼吸j执行 - 10.1183 / 13993003.00177-2020 SP - 2000177 AU - 金，延郁AU - 康惠凛AU - 权，Byoung洙AU - 林，宋尹AU - 李，妍珠AU - 公园，钟孙AU - 赵，杨宰AU - 尹豪伊尔AU - 李炅元AU - 李，宰豪AU - 李椿泽Y1 - 2020年1月1日UR - //www.qdcxjkg.com/content/early/2020/05/29/13993003.00177-2020.abstract N2 -背景虽然肺癌使用低剂量计算机断层扫描（LDCT）筛选现在被广泛应用于临床实践中，特点和不吸烟者与屏幕检测到的结节的诊断程序的结果仍不清楚。We aimed to determine the incidence of nodules considered for invasive biopsy and evaluate the final diagnoses and procedure-related complications in never-smokers in comparison to ever-smokers who underwent LDCT screening.Methods We evaluated 37 436 asymptomatic adults (17 968 never-smokers and 19 468 ever-smokers) who underwent LDCT screening for lung cancer between January 2009 and December 2018 at a tertiary centre in South Korea. The rates of invasive diagnostic procedures for detected nodules and related complications, and the diagnostic outcomes were determined in the never-smoker and ever-smoker groups.Results Among the never-smokers, 2908/17 968 (16.2%) had positive nodules. Overall, 139/17 968 (0.77%) never-smokers and 194/19 468 (1.00%) ever-smokers underwent invasive biopsy (p=0.022). Lung cancer was diagnosed in 84/17 968 (0.47%) of never-smokers and 123/19 468 (0.63%) of ever-smokers (p=0.032). The proportions of participants diagnosed with benign disease after invasive biopsy (false-positive) were 50/17 968 (0.28%) and 69/19 468 (0.35%) in the never-smoker and ever-smoker groups (p=0.191). Multivariate analyses revealed no significant associations of smoking with the risk of a false-positive diagnosis (OR=0.98, 95% CI=0.62–1.57) and complications (OR=1.33, 95% CI=0.65–3.73) after biopsy. Of the 84 never-smokers with lung cancer, 82/84 (97.6%) had adenocarcinoma, and 75/84 (89.3%) were in stage I with a favourable prognosis.Conclusions LDCT screening in never-smokers resulted in a notable detection rate of lung nodules, which warranted invasive biopsy. The lung cancer detection rate was lower in never-smokers than in ever-smokers. However, no significant differences in the false-positive and complication rates were observed between the two groups. Accordingly, a more specifically tailored management strategy is needed for screen-detected nodules in Asian never-smokers.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Kim has nothing to disclose.Conflict of interest: Dr. Kang has nothing to disclose.Conflict of interest: Dr. Kwon has nothing to disclose.Conflict of interest: Dr. Lim has nothing to disclose.Conflict of interest: Dr. Lee has nothing to disclose.Conflict of interest: Dr. Park has nothing to disclose.Conflict of interest: Dr. Cho has nothing to disclose.Conflict of interest: Dr. Yoon has nothing to disclose.Conflict of interest: Dr. Lee has nothing to disclose.Conflict of interest: Dr. Lee has nothing to disclose.Conflict of interest: Dr. Lee has nothing to disclose. ER -