独立预测因素与LDCT肺癌查结果阳性后患者拒绝侵入性诊断程序相关
Bojan Zaric1,2, Jelena Djekic Malbasa1,2, Tomi Kovacevic1,2
1Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
Diagnostics (Basel, Switzerland)
|March 14, 2026
概括
在阳性低剂量计算机断层扫描 (LDCT) 查后拒绝侵入性诊断程序是一个重大挑战. 诸如多病症和吸烟史等因素影响拒绝,影响肺癌查计划的有效性.
科学领域:
- 医学成像和诊断 医学成像和诊断
- 公共卫生和流行病学
- 在瘤学瘤学.
背景情况:
- 低剂量计算机断层扫描 (LDCT) 查显著降低了肺癌死亡率.
- LDCT查的有效性取决于在阳性结果后完成诊断程序.
- 拒绝推的侵入性诊断程序是对查有效性的未经研究的障碍.
研究的目的:
- 为了确定与患者拒绝入侵诊断程序的相关因素,积极的LDCT肺癌查后.
- 分析影响这种拒绝的人口,临床,吸烟相关和感知因素.
- 评估拒绝对诊断途径和查计划有效性的影响.
主要方法:
- 参与多中心LDCT肺癌查计划的参与者的回顾性观察性研究.
- 包括2020年9月至2025年10月期间连续选的参与者.
- 对阳性LDCT发现 (肺RADS 4A,4B,4X) 和在六个月内拒绝侵入性手术的分析.
- 多变量后勤回归以确定拒绝的独立预测因子.
主要成果:
- 在10261名查人员中,4.7%的LDCT结果为阳性,12.5%的人拒绝进行侵入性评估.
- 多种疾病,以前的恶性瘤,更高的累积吸烟暴露和查中心独立地与拒绝有关.
- 对肺癌风险的个人担忧增加与较低的拒绝率相关.
- 支气管镜检查的时间因中心和年份而异;手术的时间是一致的.
结论:
- 拒绝侵袭性诊断后阳性LDCT查是一个实质性的实施挑战.
- 患者的脆弱性 (多发病,癌症) 和系统因素 (查中心) 影响拒绝率.
- 改善风险沟通和优化诊断途径可以提高查的连续性和有效性.
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