WONCA研究论文摘要汇编——肺癌筛查假阳性结果累计发生率

发布时间：2018-06-14 08:17

  本文选题：假阳性结果 + 筛查试验　； 参考：《中国全科医学》2011年11期

【摘要】：背景直面消费者推荐做肺癌筛查有所增长,尤其低剂量CT。然而,对健康者筛查暴露潜在损害以及低剂量CT累计假阳性率从未有过正式报告。目的对参加1年或2年肺癌筛查至少有1次假阳性结果的累积风险及不必要的诊断性检查率进行量化。设计低剂量CT与胸部X线随机对照试验。设施国家肺癌筛查试验的可行性研究。病人为现或曾吸烟者,年龄55～74岁,≥30包/年吸烟史,无肺癌史(n=3 190)。干预随机纳入低剂量CT组和胸部X线组,重复1次年度筛查;最后筛查后跟踪1年。根据被检者的年龄、性别和研究中心进行中心分层随机化。测量所定义的假阳性筛查:筛查阳性,而检验结果阴性或跟踪≥12个月未做出肺癌诊断。结果用Kaplan-Meier分析法,被检者低剂量CT检查1次或更多次假阳性结果的累积率,1次筛查后为21%〔95%CI(19%,3%)〕,2次筛查后为33%〔95%CI(31%,35%)〕。胸部X线检查的假阳性结果累计率分别为9%〔95%CI(8%,11%)〕和15%〔95%CI(13%,16%)〕。总计,低剂量CT检查假阳性者中有7%和胸部X线检查假阳性者中有4%做了侵入性手术。有限性限于2回合筛查。二次筛查后跟踪限于12个月。有可能忽视了假阴性率。结论仅经2个年度筛查后,尤其是低剂量CT,肺癌筛查假阳性结果就存在着客观的风险。这些方法导致的经济、心理社会和身体负担,还需做进一步研究。
[Abstract]:Background Direct consumer recommendation for lung cancer screening has increased, especially in low dose CTLs. However, potential damage to screening exposure and cumulative false positive rates of low-dose CT have never been officially reported. Objective to quantify the cumulative risk and unnecessary diagnostic rate of false positive results at least once in one or two years of lung cancer screening. A randomized controlled trial of low dose CT and chest X-ray was designed. Facility National Lung Cancer screening trial Feasibility study. The patient was a current or former smoker, aged 55 to 74 years, with a smoking history of more than 30 packs / year and no history of lung cancer. The intervention was randomized into low dose CT group and chest X-ray group, repeated once a year and followed up for 1 year after the final screening. The center was stratified and randomized according to the age, sex and research center of the subjects. Measurement of false positive screening: screening positive, but negative test results or follow-up 鈮，

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