病变忽视和晚期诊断检查可能会损害低剂量 CT (LDCT) 筛查肺癌 (LC) 的效果，意味着疾病处于更晚期且难以治愈。我们假设右下叶 (RLL) 的奇点食管隐窝 (AER) 可能是 LC 筛查中容易忽视病变的区域。两位放射科医生回顾了在活动臂中观察到的所有屏幕检测到的事件 LC 的 LDCT 检查。 2项随机临床试验：ITALUNG和国家肺部筛查试验。根据 Lung-RADS 1.1 建议，将 AER 中的患者与 RLL 其余部分中的患者进行比较，以了解诊断滞后、大小、分期和死亡率方面可能存在的差异。 51 例筛查检测到的事件 LC 中，有 6 例 (11.7%) RLL 位于 AER。 AER LC 的诊断滞后时间（平均 14±9 个月）明显长于剩余 RLL 中的 LC（平均 7.3±1 个月）。诊断时的大小和分期没有显着差异。 AER 中所有 6 名 LC 受试者以及剩余 RLL 中 45 名 LC 受试者中的 16 名 (35.5%) 在中位随访 12 年后死于 LC。我们的回顾性研究表明，AER 可能代表了由于检测或解释错误，RLL 的肺部区域很容易被忽视，这可能会给接受 LC 筛查的受试者带来不利后果。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

Lesion overlooking and late diagnostic workup can compromise the efficacy of low-dose CT (LDCT) screening of lung cancer (LC), implying more advanced and less curable disease stages. We hypothesized that the azygos esophageal recess (AER) of the right lower lobe (RLL) might be an area prone to lesion overlooking in LC screening.Two radiologists reviewed the LDCT examinations of all the screen-detected incident LCs observed in the active arm of 2 randomized clinical trials: ITALUNG and national lung screening trial. Those in the AER were compared with those in the remainder of the RLL for possible differences in diagnostic lag according to the Lung-RADS 1.1 recommendations, size, stage, and mortality.Six (11.7%) of 51 screen-detected incident LCs of the RLL were located in the AER. The diagnostic lag time was significantly longer (P=0.046) in the AER LC (mean 14±9 mo) than in the LC in the remaining RLL (mean 7.3±1 mo). Size and stage at diagnosis were not significantly different. All 6 subjects with LC in the AER and 16 (35.5%) of 45 subjects with LC in the remaining RLL (P=0.004) died of LC after a median follow-up of 12 years.Our retrospective study indicates that AER might represent a lung region of the RLL prone to have early LC overlooked due to detection or interpretation errors with possible detrimental consequences for the subject undergoing LC screening.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.