基于现有的肺癌风险和螺旋计的个性化查强度
Patrick Goodley1,2, Hana Zahed3, Haval Balata1,2
1Division of Immunology, Immunity to Infection and Respiratory Medicine, The University of Manchester, Manchester, UK.
ERJ open research
|March 11, 2026
概括
使用风险模型的个性化肺癌查间隔可以通过扩大低风险个体的查来提高成本效益. 这种方法有助于将资源集中在高风险患者身上,减少间隔癌症和查危害.
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.
- 生物统计学 生物统计学
背景情况:
- 目前的肺癌查计划通常使用固定的年度或两年间隔.
- 风险模型可以为个性化查间隔提供信息,以提高成本效益并减少间隔癌症.
- 螺旋计气流阻塞是肺癌风险的潜在生物标志物,需要进行预测价值的调查.
研究的目的:
- 评估现有风险模型在预测肺癌查下一轮风险方面的表现.
- 评估是否结合螺旋计数据 (FEV1 % pred) 可以提高风险预测和查效率.
- 为了确定基于风险模型的个性化查间隔是否可以优化肺癌查计划.
主要方法:
- 风险模型 (PLCOm2012,LCRAT+CTneg) 在曼彻斯特和国家肺部查试验 (NLST) 队列中进行了测试,以预测下一轮风险.
- 在NLST子研究 (ECOG-ACRIN) 中,模型进行了调整,以包括FEV1%前.
- 模型的性能被评估使用歧视指标,如曲线下的面积 (AUC).
主要成果:
- 较高的风险分数与在下一次查间隔内增加的肺癌检测率相关.
- PLCOm2012模型显示AUC为0.72,而LCRAT+CTneg在外部验证中实现了0.75的AUC.
- 添加FEV1的百分比仅在歧视方面提供了适度的改善 (ΔAUC 0.010.04).
结论:
- 基线风险评估可以确定较低风险的个体进行延长查间隔,降低成本和危害.
- 将资源集中在高风险人群上,可以防止延迟检测肺癌.
- 在肺癌查中,FEV1 % pred不太可能显著提高下一轮风险预测.
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