ABSTRACT:Abstract(#br)Objective(#br)The association between access to CT facilities for lung cancer screening and population characteristics is understudied. We aimed to determine the relationship between census tract–level socioeconomic characteristics (SEC) and driving distance to an ACR-accredited CT facility.(#br)Methods(#br)Census tract–level SEC were determined from the US Census Bureau. Distance to nearest ACR-accredited CT facility was derived at the census tract level. Census tract–level multivariable regression modeling was used to determine the relationship between driving distance to a CT facility and census tract SEC, including population density (a marker of rural versus urban), gender, race, insurance status or type, and education level.(#br)Results(#br)In an adjusted multivariable model, census tract–level population density was the greatest relative determinant of distance to a CT facility. Namely, rural census tracts had relatively longer distances to CT facilities than urban census tracts ( P < .001). Census tracts with higher uninsured and undereducated (less than high school degree) people and Medicaid beneficiaries had relatively greater distances to CT facilities ( P < .001), whereas those with higher nonwhite, female, and Medicare-recipient populations had shorter distances ( P < .001).(#br)Discussion(#br)Rural populations have relatively less geographic access to CT facilities. Furthermore, other vulnerable populations, such as the uninsured, those on Medicaid, and the undereducated, may also have relatively less access to CT imaging facilities. These variations in access to CT may affect the uptake and utilization of lung cancer screening.

 

肝脏是恶性肿瘤转移最常见的靶器官之一,转移率为11.1%;恶性肿瘤患者40%出现肝转移.转移性肝癌不仅在原发肿瘤来源、肿瘤基因和生物学行为等方面存在个体化差异,而且在肿瘤进展阶段、解剖学特点、机体功能、并发症等方面亦存在差异.针对转移肿瘤来源和途径不同,转移性肝癌治疗涉及原发肿瘤和肝转移肿瘤两个方面,如何合理选择手术、局部消融、化疗、分子靶向药物、内分泌、生物免疫、放射等治疗方法及治疗时机,是转移性肝癌治疗的关键.利用现代先进的影像学技术明确转移性肝癌肿瘤大小、数目、部位、血供等情况,为精确制定转移性肝癌个体化治疗方案提供客观依据.目前任何一种治疗转移性肝癌的方法均有其各自的适应证,对于不能手术根治切除的转移性肝癌,单一治疗方法难以达到治愈或控制肿瘤进展,需要两种或两种以上治疗方法有机地联合,达到协同增效的治疗效果.

目的:研究螺旋CT检查对转移性肝癌的诊断作用。方法:选取2017年3月到2018年8月在某院进行疑似转移性肝癌378例作为本次研究对象,对所有患者均使用胸部X线和螺旋CT进行相关检查,比较经两种不同检查方式的患者的诊断情况。结果:经分析发现,在378例疑似转移性肝癌患者中,经胸部X线检查出发生病变的检出率为67.72%(256例),经螺旋CT检查出发生病变的检出率为94.18%(356例),两组比较可见,经螺旋CT检查后的发生病变的检出率均高于经胸部X线检查,两组比较有统计学意义(P <0.05)。结论:在对于疑似转移性肝癌过程中,通过应用螺旋CT进行相关检查,不仅可以及时发现疾病,还能做出准确诊断,效果显著,推荐临床应用。

绘佳医疗