肺癌查的低剂量计算机断层扫描在结核流行国家:系统性审查和元分析
Vikram Damaraju1, Juhu Kiran Krushna Karri1, Gayathri Gandrakota1
1Department of Pulmonary Medicine, All India Institute of Medical Sciences, Mangalagiri, India.
概括
肺癌查 (LCS) 使用低剂量计算机断层扫描 (LDCT) 在高结核负担的国家 (HTBC) 显示可比的查阳性率 (SPR) 和肺癌检测率 (LCDR). 建议使用肺-RADS标准,而不是NLST标准,以减少HTBC的错误阳性.
科学领域:
- 肺部医学 肺部医学
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
背景情况:
- 低剂量计算机断层扫描 (LDCT) 用于肺癌查 (LCS) 降低了死亡率.
- 高结核病负担国家 (HTBC) 面临的挑战是,由于先前的结核病 (TB) 病变,最不发达国家 (LDCT) 的错误阳性率很高.
- 评估HTBC中LDCT查的有效性至关重要.
研究的目的:
- 在高结核负担国家 (HTBC) 评估最不发达国家查的查阳性率 (SPR).
- 为了比较HTBC中不同查标准的有效性.
主要方法:
- 从研究开始到2023年12月6日,对44项研究 (477,424人) 的系统审查和元分析.
- 主要结果:SPR;次要结果:肺癌检测率 (LCDR).
- 随机效应模型用于数据聚合;多变量元回归用于因子分析.
主要成果:
- 聚合的SPR为18.36%和LCDR为0.94%.
- 肺成像报告和数据系统 (Lung-RADS) 标准与国家肺部查试验 (NLST) 标准 (25.6%) 相比,产生较低的SPR (10.4%),具有类似的LCDR.
- 超回归表明NLST标准具有更高的SPR,尽管注意到异质性和出版偏差.
结论:
- 在HTBC中LCS的LDCT显示SPR和LCDR与结核病发病率较低的地区相比较.
- 肺RADS标准优于HTBC中LCS的NLST标准,以尽量减少假阳性率.
- 进一步的研究应该解决元分析中的异质性和偏见.
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