与延迟肺癌诊断和肺癌查计划手术相关的因素
Raquelle El Alam1,2, Mark M Hammer1,2, Suzanne C Byrne1,2
1Department of Radiology, Brigham and Women's Hospital.
Journal of thoracic imaging
|March 8, 2024
概括
肺癌诊断和治疗的延迟与活跃吸烟和在手术前接受额外的CT扫描有关. 在肺癌查计划中解决这些因素可以改善患者的治疗结果.
科学领域:
- 肺部病理学 肺部病理学
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 及时诊断和治疗对于肺癌的生存至关重要.
- 诊断和手术途径的延迟可能会对患者的结果产生负面影响.
- 肺癌查 (LCS) 计划旨在早期检测肺癌,但仍可能出现延迟.
研究的目的:
- 在肺癌查计划中,在肺结节检测后,识别与活检和手术延迟相关的因素.
- 分析患者特征,程序因素和治疗延迟之间的关系.
主要方法:
- 在2015年5月至2021年10月的恶性肺结节 (Lung-RADS 4B/4X) 的LCS计划中对患者的回顾性评估.
- 定义的延迟是从查CT到第一次组织采样>30天,从查CT到手术>60天.
- 评估了延迟与患者人口统计,吸烟状况,收入,语言,肺RADS类别和手术地点之间的关联.
主要成果:
- 发现了185种肺癌;150种肺癌经过切除. 第一次组织采样的中位时间为42天;手术的中位时间为52天.
- 69%的患者在第一次组织采样中出现延迟,40%的患者在手术中出现延迟.
- 活跃吸烟与延迟组织采样有显著的关联 (OR:3.0). 在手术前进行增强诊断CT与延迟手术有很强的关联 (OR: 30).
结论:
- 目前的吸烟状况和接受手术前诊断CT扫描是导致LCS计划中的肺癌治疗延迟的重要因素.
- 这些发现突出了潜在的干预领域,以简化通过查发现的肺癌患者的诊断和治疗途径.
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