改变游戏规则的20年:肺癌查的进展和未来方向
Stephen Lam1, David R Baldwin2, Anand Devaraj3
1Department of Basic and Translational Sciences, British Columbia Cancer Research Institute, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
概括
使用低剂量计算机断层扫描 (LDCT) 的肺癌查 (LCS) 在高危人群中显著降低了20%以上的死亡率. 人工智能和风险预测的持续进步有望进一步改善早期检测和患者的结果.
科学领域:
- 肺部病理学 肺部病理学
- 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) 的肺癌查 (LCS) 已被证明有效降低肺癌死亡率,NLST和NELSON等具有里程碑意义的试验显示超过20%的减少.
- 现在,LDCT是高风险人群早期检测的护理标准,有13个国家实施国家或区域查计划.
研究的目的:
- 审查肺癌查的现状和未来方向.
- 突出风险预测,成像分析和人工智能集成方面的进展.
- 讨论改善查普及的策略,扩大查标准,并将LCS与其他健康倡议整合起来.
主要方法:
- 对具有里程碑意义的临床试验 (NLST,NELSON) 和当前全球实施LCS计划的审查.
- 分析最近的技术进步,包括人工智能用于结节检测和风险评估.
- 审查提高查可访问性,患者参与度和与戒烟和其他疾病检测相结合的战略.
主要成果:
- 现实世界的证据支持改善肺癌阶段分布,并建议减少死亡率.
- 人工智能集成增强了结节检测,恶性瘤风险预测和查间隔个性化.
- 将查扩展到从未吸烟者和整合偶然发现 (例如,冠状动脉疾病,COPD) 显示出潜在的更广泛的健康益处.
结论:
- 肺癌查是肺癌控制的基石,持续的创新对于最大限度地提高全球利益和公平至关重要.
- 风险分层,成像技术和生物标志物集成方面的持续进步对于LCS的演变至关重要.
- 协调数据标准,质量指标和劳动力培训对于持续高质量实施LCS计划至关重要.
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