Thorax:可以将随访CT筛查个性化为每1年和每2年的肺癌风险模型

2018-04-01 xiangting MedSci原创

使用患者特征和基线扫描形态学的多项式模型,在将受试者分配为1年或2年的筛查间隔上有显著的优越性。

所有的肺癌CT筛查试验均使用固定的随访间隔,这种间隔可能并不是最佳的。在这项研究中,研究人员建立了新的肺癌风险模型,将筛查间隔个性化为1年或2年,并将其与现有模型进行了比较。

研究纳入了全国肺部筛查试验(2002 - 2010年)CT组的受试者,这些受试者接受了基线CT扫描和首次年度随访扫描,并且在第一年没有被诊断肺癌。计算每个模型的真假阳性值和曲线下面积。使用引导进行内部验证。

分析包括24542名受试者的数据。多项式、患者特征、直径、Patz和PanCan模型的准确度分别为0.785、0.693、0.697、0.666和0.727。在24542名受试者中,174名(0.71%)在第1次和第2次年度随访期间被诊断为肺癌。使用多项式模型,第1轮随访筛查后的次年没有出现肺癌的24368名受试者中分别有2558(10.4%,95%CI 10.0%至10.8%),7544(30.7%,30.2%至31.3%),10947(44.6%,44.0%至45.2%),16710(68.1% ,67.5%至68.7%)和20023名(81.6%,81.1%至92.1%)受试者可以安全跳过,174名肺癌的延误诊断分别为0(0.0%,0.0%至2.7%),8(4.6%,2.2%至9.2%),17(9.8%,6.0%至15.4%),44(25.3%,19.2%至32.5% )和70(40.2%,33.0%至47%)。

使用患者特征和基线扫描形态学的多项式模型,在将受试者分配为1年或2年的筛查间隔上有显著的优越性。实施个性化的随访间隔,每延误诊断1例肺癌的同时将使数以百计的受试者可以跳过筛查周期。

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    2018-06-28 sjq027
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