The insufficiency of CT examination in early detection of central lung squamous cell carcinoma and squamous epithelial precancerous lesions
- PMID: 38443800
- PMCID: PMC10916110
- DOI: 10.1186/s12885-024-12052-9
The insufficiency of CT examination in early detection of central lung squamous cell carcinoma and squamous epithelial precancerous lesions
Abstract
Background: CT examination for lung cancer has been carried out for more than 20 years and great achievements have been made in the early detection of lung cancer. However, in the clinical work, a large number of advanced central lung squamous cell carcinoma are still detected through bronchoscopy. Meanwhile, a part of CT-occult central lung squamous cell carcinoma and squamous epithelial precancerous lesions are also accidentally detected through bronchoscopy.
Methods: This study retrospectively collects the medical records of patients in the bronchoscopy room of the Endoscopy Department of Zhejiang Cancer Hospital from January 2014 to December 2018. The inclusion criteria for patients includes: 1.Patient medical records completed, 2.Without history of lung cancer before the diagnosis and first pathological diagnosis of primary lung cancer, 3.Have the lung CT data of the same period, 4.Have the bronchoscopy records and related pathological diagnosis, 5.The patients undergoing radical surgical treatment must have a complete postoperative pathological diagnosis. Finally, a total of 10,851 patients with primary lung cancer are included in the study, including 7175 males and 3676 females, aged 22-98 years. Firstly, 130 patients with CT-occult lesions are extracted and their clinical features are analyzed. Then, 604 cases of single central squamous cell carcinoma and 3569 cases of peripheral adenocarcinoma are extracted and compares in postoperative tumor diameter and lymph node metastasis.
Results: 115 cases of CT-occult central lung squamous cell carcinoma and 15 cases of squamous epithelial precancerous lesions are found. In the total lung cancer, the proportion of CT-occult lesions is 130/10,851 (1.20%). Meanwhile, all these patients are middle-aged and elderly men with a history of heavy smoking. There are statistically significant differences in postoperative median tumor diameter (3.65 cm vs.1.70 cm, P < 0.0001) and lymph node metastasis rate (50.99% vs.13.06%, P < 0.0001) between 604 patients with operable single central lung squamous cell carcinoma and 3569 patients with operable peripheral lung adenocarcinoma. Of the 604 patients with squamous cell carcinoma, 96.52% (583/604) are male with a history of heavy smoking and aged 40-82 years with a median age of 64 years.
Conclusions: This study indicates that the current lung CT examination of lung cancer is indeed insufficiency for the early diagnosis of central squamous cell carcinoma and squamous epithelial precancerous lesions. Further bronchoscopy in middle-aged and elderly men with a history of heavy smoking can make up for the lack of routine lung CT examination.
Keywords: Bronchoscopy; CT examination; CT-occult; Central; Lung cancer; Squamous cell carcinoma; Squamous epithelial precancerous lesions.
© 2024. The Author(s).
Conflict of interest statement
The authors declare they have no competing interests.
Figures
Similar articles
-
The predictive value of the change of the number of pixels under different CT value intervals in the CT-occult central lung squamous cell carcinoma and squamous epithelial precancerous lesions.BMC Pulm Med. 2023 Nov 3;23(1):426. doi: 10.1186/s12890-023-02732-w. BMC Pulm Med. 2023. PMID: 37924039 Free PMC article.
-
False-negative rate after positron emission tomography/computer tomography scan for mediastinal staging in cI stage non-small-cell lung cancer.Eur J Cardiothorac Surg. 2012 Jul;42(1):93-100; discussion 100. doi: 10.1093/ejcts/ezr272. Epub 2012 Jan 20. Eur J Cardiothorac Surg. 2012. PMID: 22290911 Clinical Trial.
-
A randomized trial of CT fluoroscopic-guided bronchoscopy vs conventional bronchoscopy in patients with suspected lung cancer.Chest. 2008 Sep;134(3):507-513. doi: 10.1378/chest.08-0160. Epub 2008 Jul 18. Chest. 2008. PMID: 18641093 Clinical Trial.
-
[Pulmonary mucosa-associated lymphoid tissue lymphoma concurrent with lung squamous cell carcinoma: a case report and literature review].Zhonghua Jie He He Hu Xi Za Zhi. 2020 Dec 12;43(12):1071-1076. doi: 10.3760/cma.j.cn112147-20200729-00859. Zhonghua Jie He He Hu Xi Za Zhi. 2020. PMID: 33333642 Review. Chinese.
-
Early diagnosis of lung cancer.Clin Chest Med. 2010 Mar;31(1):39-47, Table of Contents. doi: 10.1016/j.ccm.2009.08.004. Clin Chest Med. 2010. PMID: 20172431 Review.
References
-
- Hyuna Sung J, Ferlay RL, Siegel, Global Cancer Statistics. 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries.CA Cancer J Clin. 2021;71(3):209–249.10.3 322/caac.21660. - PubMed
-
- He J, Li N, Chen WQ, et al. Beijing)] Zhonghua Zhong Liu Za Zhi. 2021;43(3):243–68. 10.3760/cma.j.cn112152-20210119-00060..[China guideline for the screening and early detection of lung cancer(2021. - PubMed
-
- Chen WQ, Cao MM. Strengthening cancer early diagnosis and treatment,implementing the strategy of healthy China [J].China Cancer,2019,28(9):643–5.10.11735/j.issn.1004-0242.
-
- ChenWQ LN. ShiJF, etal.Progress of cancer screening program in urban China. [J] China Cancer,2019,28(1):23–5.10.11735/j.issn.1004-0242.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical