LDCT lung cancer screening in populations at different risk for lung cancer
LDCT lung cancer screening in populations at different risk for lung cancer
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DOI：
10.1136/bmjresp-2019-000455
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发表时间：
2020-03-01
影响因子：
4.1
通讯作者：
Szarf, Gilberto
中科院分区：
文献类型：
--
作者：
da Silva Teles, Gustavo Borges;Sandoval Macedo, Ana Carolina;Szarf, Gilberto
低剂量CT（LDCT）肺癌筛查选择标准的改进有助于纳入更多患有肺癌或将发展为肺癌的个体，同时避免显着的成本增加。我们评估了基线结果的LDCT肺癌筛查的异质性风险的人群中肺癌cancer.Methods LDCT肺癌筛查一起实施的预防性健康计划在巴西的一家私立医院。包括45岁以上的个人，吸烟者和前吸烟者，无论烟草暴露如何。根据国家肺筛查试验（NLST）合格性标准和PLCOm 2012 6年肺癌风险对患者进行分类。结果472例患者的LDCT扫描结果显示，3例肺腺癌被诊断。CT阳性率（肺RADS 3/4）显著高于NLST组（p=0.019）（10.1%（95% CI，5.9%-16.9%））（3.6%（95% CI，2.62%至4.83%））和PLCOm 2012高风险组（14.3%（95% CI，6.8%至27.7%）），而PLCOm 2012低风险组（3.7%（95% CI，2.9%至4.8%））（p=0.016）。PLCOm 2012高风险患者（5.7%（95%CI，2.5%-12.6%））的肺癌检出率也显著高于PLCOm 2012低风险个体（0.2%（95%CI，0.1%-1.1%））（p=0.018）。NLST标准的假阳性率（16.4%（95% CI，13.2%至20.1%））较高（p= 0.0151，因为合格标准似乎可以提高肺癌筛查的有效性。
Introduction The improvement of low-dose CT (LDCT) lung cancer screening selection criteria could help to include more individuals who have lung cancer, or in whom lung cancer will develop, while avoiding significant cost increase. We evaluated baseline results of LDCT lung cancer screening in a population with a heterogeneous risk profile for lung cancer.Methods LDCT lung cancer screening was implemented alongside a preventive health programme in a private hospital in Brazil. Individuals older than 45 years, smokers and former smokers, regardless of tobacco exposure, were included. Patients were classified according to the National Lung Screening Trial (NLST) eligibility criteria and to PLCOm2012 6-year lung cancer risk. Patient characteristics, CT positivity rate, detection rate of lung cancer and false-positive rate were assessed.Results LDCT scans of 472 patients were evaluated and three lung adenocarcinomas were diagnosed. CT positivity rate (Lung-RADS 3/4) was significantly higher (p=0.019) in the NLST group (10.1% (95% CI, 5.9% to 16.9%)) than in the non-NLST group (3.6% (95% CI, 2.62% to 4.83%)) and in the PLCOm2012 high-risk group (14.3% (95% CI, 6.8% to 27.7%)) than in the PLCOm2012 low-risk group (3.7% (95% CI, 2.9% to 4.8%)) (p=0.016). Detection rate of lung cancer was also significantly higher (p=0.018) among PLCOm2012 high-risk patients (5.7% (95% CI, 2.5% to 12.6%)) than in the PLCOm2012 low-risk individuals (0.2% (95% CI, 0.1% to 1.1%)). The false-positive rate for NLST criteria (16.4% (95% CI, 13.2% to 20.1%)) was higher (p= 0.0151 as an eligibility criterion seems to increase lung cancer screening effectiveness.