低劑量電腦斷層在肺癌篩檢的角色與運用

10.6666/ClinMed.202105_87(5).0045

沈佳儀；邱昭華

低劑量電腦斷層（low-dose computed tomography, LDCT） ； 肺癌（lung cancer） ； 肺癌篩檢（lung cancer screening）

臨床醫學月刊

87卷5期（2021 / 05 / 28）

277 - 282

繁體中文

肺癌具有高發生率及高死亡率，多數患者診斷肺癌時都已經是第三或第四期，雖然近年相關治療進步許多，但如何早期發現肺癌，依然是肺癌研究最重要的課題之一。低劑量電腦斷層，因為大幅降低輻射劑量、又兼具高敏感偵測肺結節的優勢，確實有運用在肺癌篩檢的潛力。近年陸續公布幾個大型臨床試驗，證實低劑量電腦斷層篩檢在高風險吸菸族群的確能有效降低肺癌死亡率，已被一些國家納入其癌症篩檢政策。然而不可諱言，其伴隨而來的過度診斷、偽陽性、以及成本效益等問題，仍有討論空間。對於非吸菸者，則尚未有完整的共識，臺灣目前正在進行的研究也許未來能為全世界提供指引。除了低劑量電腦斷層，搭配其他生物標記，或是運用人工智慧，都是未來可能的發展方向。臨床醫師和患者要透過討論，找到最適合的篩檢建議，才能發揮最大的效能。

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