对肺部新形成症扩张的查标准评估 (SCREEN) II
Bright Huo1, Katerina-Maria Kontouli1, Daria Manos1
1From the Faculty of Medicine, Dalhousie University, Halifax, N.S. (Huo); the Department of Primary Education, School of Education, University of Ioannina, Ioannina, Greece (Kontouli); the Department of Diagnostic Radiology, Dalhousie University, Halifax, N.S. (Manos); the Department of Pathology, Dalhousie University, Halifax, N.S. (Xu, Fris); the Department of Urology, Dalhousie University, Halifax, N.S. (Chun); the Division of Thoracic Surgery, Department of Surgery, Dalhousie University, Halifax, N.S. (Wallace, French).
肺癌查标准可能需要扩展. 不符合查条件的轻度或从不吸烟者显示出更高的EGFR和PIK3CA阳性肺癌率,这表明在未来的查标准中需要分子分析.
科学领域:
- 在瘤学瘤学.
- 肺部病理学 肺部病理学
- 遗传学 是一个遗传学.
背景情况:
- 目前的肺癌查资格标准 (年龄,吸烟史) 可能会排除某些人群.
- 轻度吸烟或从不吸烟的人和重度吸烟的人可能在与肺癌相关的分子和免疫学标记上有所不同.
- 评估这些差异对于完善查指南至关重要.
研究的目的:
- 为了比较分子突变 (KRAS,EGFR,BRAF,PIK3CA,ALK,PD-L1) 和轻度或从不吸烟者和重度吸烟者之间的存活率.
- 评估目前的肺癌查标准是否足够识别有风险的个体.
- 为了告知潜在的扩大肺癌查资格.
主要方法:
- 在加拿大高等院校对1156例肺癌病例 (2005-2018) 的回顾性审查.
- 多变量逻辑回归用于比较突变率和存活率.
- 基于国家肺部查试验 (NLST) 和荷兰-莱文斯肺癌查研究 (NELSON) 标准的分析.
主要成果:
- 在NLST和NELSON模型中,轻度吸烟或从未吸烟的人更有可能患有EGFR阳性肺癌.
- 在轻度吸烟或从未吸烟的人群中,PIK3CA阳性肺癌的发生频率更高.
- 屏幕不合格的轻烟或从不吸烟者更经常来自高暴露地区,在NELSON模型中死亡风险更高.
结论:
- 不符合查条件的轻度或从不吸烟者与符合查条件的重度吸烟者相比,具有较高的EGFR和PIK3CA阳性肺癌率.
- 对于未来的肺癌查标准的制定,应考虑分子分析.
- 这可能会导致更具包容性和有效的肺癌查策略.
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