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我们应该查COPD吗? - 通过肺癌查的镜头来看
Robert P Young1, Raewyn J Scott1
1Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Expert review of respiratory medicine
|September 20, 2023
概括
高风险吸烟者的螺旋计,即使是无症状的,也将许多人重新归类为慢性阻塞性肺病 (COPD). 这有助于优化肺癌查的有效性,并识别潜在的危害.
科学领域:
- 肺部医学 肺部医学
- 诊断成像 诊断成像 诊断成像
- 流行病学 流行病学
背景情况:
- 美国预防服务工作组建议不对无症状成年人进行慢性阻塞性肺病 (COPD) 查.
- 在高风险吸烟者中,既有症状又无症状的例行精神测量可能具有显著的效用.
- 肺癌查的有效性可能会受到并发性疾病和螺旋计分类的影响.
研究的目的:
- 评估常规螺旋计在接受肺癌查的高风险吸烟者的实用性.
- 确定螺旋计如何根据空气流量限制和其他螺旋计模式重新分类个体.
- 评估螺旋计子组对肺癌查结果的影响.
主要方法:
- 从国家肺部查试验 (ACRIN手臂) 中,对18463名高风险的现有或前吸烟者的二次分析.
- 在基线时对所有参与者进行了支气管扩展前螺旋测量.
- 将螺旋计结果与自我报告的COPD诊断进行比较,并确定空气流量限制 (COPD) 和保留比率受损螺旋计 (PRISm).
主要成果:
- 报告COPD诊断的参与者中,只有11%的人实际上有空气流量限制;9%的人有GOLD 0 COPD前.
- 在"无症状"的参与者中,23%的患者患有查检测到的COPD,13%的患者患有PRISM.
- 螺旋测量重新分类了45%的高风险队列,确定了可以将肺癌查效率优化2-6倍的子组.
结论:
- 肺癌查结果根据螺旋计定义的COPD亚组有显著差异.
- 查螺旋计,结合并发性疾病评估,识别了那些受益最多或可能受到肺癌查伤害的人.
- 高风险吸烟者的常规螺旋计对于个性化肺癌查策略非常有价值.
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