在临床实践中基于风险的肺癌查
Matthew M Rode1, Anne-Marie G Sykes2, Mark S Allen3
1Mayo Clinic School of Medicine, 200 First Street SW Rochester, MN, USA 55905.
概括
使用PLCO风险计算器进行的肺癌查发现的癌症数量超过了单独使用USPSTF指南的癌症数量. 较高的潜在风险与肺癌患病率和发病率的增加相关,具有较低的侵入性手术率.
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:
- 目前美国肺癌查指南仅依赖年龄和吸烟史.
- 个性化风险评估工具可能为肺癌提供更好的风险分层.
研究的目的:
- 评估PLCOm2012风险计算器在识别肺癌方面的有效性.
- 为了比较USPSTF2013和PLCOm2012标准之间的肺癌检测率.
主要方法:
- 一个多站点肺癌查计划招募了通过USPSTF2013或PLCOm2012 (≥1.34%风险) 合格的患者.
- 进行了入侵性手术的回顾性抽象.
- 肺癌发病率和患病率在PLCOm2012定义的风险层之间进行了比较.
主要成果:
- 在2471名查患者中检测到114种肺癌.
- 84%的患者和91%的癌症患者符合USPSTF和PLCO的标准.
- 与最低风险组相比,PLCOm2012风险组中肺癌的患病率是最高风险组的7倍以上. 只有PLCOm2012的合格者 (3.6/1000人年) 的发病率高于只有USPSTF2013的合格者 (0/1000人年).
- 74%的查检测到的NSCLC是I或II阶段. 查的侵入性干预措施很低 (4.3%).
结论:
- PLCOm2012风险计算器发现了更多的肺癌,特别是那些不仅符合USPSTF2013标准的患者.
- 肺癌的患病率和发病率随着潜在风险得分的提高而增加.
- 使用基于风险的标准进行肺癌查,表明对良性疾病的侵袭性手术率较低.
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