Use of multiple imputation to correct for bias in lung cancer incidence trends by histologic subtype.
Use of multiple imputation to correct for bias in lung cancer incidence trends by histologic subtype.
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DOI：
10.1158/1055-9965.epi-14-0130
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发表时间：
2014-08
期刊：
影响因子：
--
通讯作者：
Caporaso NE
中科院分区：
文献类型：
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作者：
Yu M;Feuer EJ;Cronin KA;Caporaso NE
在过去的几十年里，肺癌研究和实践的进步导致了肺癌组织学诊断的改进。然而，非特异性形态学编码的差异使用和随后的改变可能导致组织学亚型发生率的人为波动，从而使时间趋势发生偏差。我们开发了一种多重插补（MI）方法，使用1975-2010年监测、流行病学和最终结果（SEER）计划的数据校正非特异性组织学肺癌发病率。对于男性腺癌和两性鳞状细胞癌，在经历了十多年的发病率下降之后，在2005年左右出现了上升趋势，这显然是组织病理学实践和编码系统变化的结果。插补后，男性腺癌和鳞状细胞癌的发生率保持下降趋势，女性鳞状细胞癌的发生率保持不变。随着新技术越来越多地识别不同组织学的分子特征，准确的组织学区分与更有效的“靶向”治疗越来越相关，因此，在患者中进行跟踪非常重要。然而，如果不纳入编码变化，组织学亚型的发病率趋势估计可能会产生误导。MI方法提供了一个有价值的工具，用于桥接不同的组织学定义，从而允许通过组织学亚型对肺癌的长期趋势进行有意义的推断。
Over the past several decades, advances in lung cancer research and practice have led to refinements of histological diagnosis of lung cancer. The differential use and subsequent alterations of non-specific morphology codes, however, may have caused artifactual fluctuations in the incidence rates for histologic subtypes, thus biasing temporal trends. We developed a multiple imputation (MI) method to correct lung cancer incidence for non-specific histology using data from the Surveillance, Epidemiology, and End Results (SEER) Program during 1975–2010. For adenocarcinoma in men and squamous in both genders, the change to a increasing trend around 2005, after more than ten years of decreasing incidence, is apparently an artifact of the changes in histopathology practice and coding system. After imputation, the rates remained decreasing for adenocarcinoma and squamous in men, and became constant for squamous in women. As molecular features of distinct histologies are increasingly identified by new technologies, accurate histological distinctions are becoming increasingly relevant to more effective 'targeted' therapies, and therefore, are important to track in patients. However, without incorporating the coding changes, the incidence trends estimated for histologic subtypes could be misleading. The MI approach provides a valuable tool for bridging the different histology definitions, thus permitting meaningful inferences about the long-term trends of lung cancer by histological subtype.