旨在调查低剂量计算机断层扫描 (LDCT) 筛查试验中诊断出的大细胞癌 (LCC) 病例的早期放射学特征和生存率。两位放射科医生共同回顾了 NLST、ITALUNG 和 LUSI 试验中观察到的筛查检测 LCC 的放射学特征2002年至2016年间，共有29,744名受试者每年接受3-5次LDCT筛查。生存或死亡原因是根据随机分组后超过 12 年的死亡率登记确定的。750 名筛查检测出肺癌 (LC) 的受试者中有 30 名 (4%) 被诊断为 LCC，其中包括 15 名流行病例和 15 名发病病例。在筛查期间另外发生了 3 例 LCC 作为间隔癌。 29 例屏幕检测到的 LCC 具有 LDCT 图像，其中 28 例显示单个、周边、边界清楚的实性结节或肿块，边缘规则光滑 (39%)、分叶状 (43%) 或毛刺状 (18%) 。 1 例表现为肺门肿块。在 9 例 LCC 中，在之前的 LDCT 检查中发现了较小的实性结节，这使我们能够计算出平均体积倍增时间 (VDT) 为 98.7 ± 47.8 天。总体五年生存率为 50%，I-II 期（存活 75%）和 III-IV 期（存活 10%）之间存在显着性 (p = 0.0001) 差异。LCC 是一种快速生长的肿瘤，可导致通过年度 LDCT 筛查逃脱检测。 LCC 通常表现为单个实性周围结节或肿块，通常具有分叶状边缘，并表现出短 VDT。 5 年生存率反映了诊断时的阶段。版权所有 © 2024 Elsevier B.V. 保留所有权利。

To investigate the early radiological features and survival of Large Cell Carcinoma (LCC) cases diagnosed in low-dose computed tomography (LDCT) screening trials.Two radiologists jointly reviewed the radiological features of screen-detected LCCs observed in NLST, ITALUNG, and LUSI trials between 2002 and 2016, comprising a total of 29,744 subjects who underwent 3-5 annual screening LDCT examinations. Survival or causes of death were established according to the mortality registries extending more than 12 years since randomization.LCC was diagnosed in 30 (4 %) of 750 subjects with screen-detected lung cancer (LC), including 15 prevalent and 15 incident cases. Three additional LCCs occurred as interval cancers during the screening period. LDCT images were available for 29 cases of screen-detected LCCs, and 28 showed a single, peripheral, and well-defined solid nodule or mass with regularly smooth (39 %), lobulated (43 %), or spiculated (18 %) margins. One case presented as hilar mass. In 9 incident LCCs, smaller solid nodules were identified in prior LDCT examinations, allowing us to calculate a mean Volume Doubling Time (VDT) of 98.7 ± 47.8 days. The overall five-year survival rate was 50 %, with a significant (p = 0.0001) difference between stages I-II (75 % alive) and stages III-IV (10 % alive).LCC is a fast-growing neoplasm that can escape detection by annual LDCT screening. LCC typically presents as a single solid peripheral nodule or mass, often with lobulated margins, and exhibits a short VDT. The 5-year survival reflects the stage at diagnosis.Copyright © 2024 Elsevier B.V. All rights reserved.