Clinical Utility of a Plasma Protein Classifier for Indeterminate Lung Nodules.
Clinical Utility of a Plasma Protein Classifier for Indeterminate Lung Nodules.
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DOI：
10.1007/s00408-015-9800-0
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发表时间：
2015-12
期刊：
影响因子：
5
通讯作者：
Kearney P
中科院分区：
文献类型：
--
作者：
Vachani A;Hammoud Z;Springmeyer S;Cohen N;Nguyen D;Williamson C;Starnes S;Hunsucker S;Law S;Li XJ;Porter A;Kearney P
不确定的肺结节的评价是一个复杂的挑战。大多数是良性的，但经常接受侵入性和昂贵的程序，以排除恶性。开发了一种血浆蛋白分类器，用于识别可能的良性结节，可以将其分类到CT监测，以避免不必要的侵入性操作。在一项前瞻性-回顾性分析中评估了该分类器的临床效用，该研究招募了475名直径为8-30 mm的结节患者，这些患者在12个部位进行了侵入性手术以确认诊断。使用该分类器，可以避免32.0%（CI 19.5-46.7）的手术和31.8%（CI 20.9-44.4）的良性结节侵入性手术（活检和/或手术）。通过分类器进行CT监测的恶性肿瘤患者为24.0%（CI 19.2-29.4）。该发生率与临床实践中描述的发生率相似（24.5%CI 16.2-34.4）。这项研究证明了肺结节的非侵入性血液检查的临床实用性。本文的在线版本（doi：10.1007/s 00408 -015-9800-0）包含补充材料，可供授权用户使用。
Evaluation of indeterminate pulmonary nodules is a complex challenge. Most are benign but frequently undergo invasive and costly procedures to rule out malignancy. A plasma protein classifier was developed that identifies likely benign nodules that can be triaged to CT surveillance to avoid unnecessary invasive procedures. The clinical utility of this classifier was assessed in a prospective–retrospective analysis of a study enrolling 475 patients with nodules 8–30 mm in diameter who had an invasive procedure to confirm diagnosis at 12 sites. Using this classifier, 32.0 % (CI 19.5–46.7) of surgeries and 31.8 % (CI 20.9–44.4) of invasive procedures (biopsy and/or surgery) on benign nodules could have been avoided. Patients with malignancy triaged to CT surveillance by the classifier would have been 24.0 % (CI 19.2–29.4). This rate is similar to that described in clinical practices (24.5 % CI 16.2–34.4). This study demonstrates the clinical utility of a non-invasive blood test for pulmonary nodules. The online version of this article (doi:10.1007/s00408-015-9800-0) contains supplementary material, which is available to authorized users.