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Chest:CT筛查检测到的小细胞肺癌特点及预后

2018-08-05 xiangting MedSci原创

LDCT的“早期检测”对SCLC预后没有影响。

既往研究关于筛查能否在早期检测到小细胞肺癌(SCLC)以及是否有生存获益的结果上存在分歧,并且这些研究的患者数量有限。

研究人员分析了国家肺部筛查试验(NLST)中低剂量计算机断层扫描(LDCT)检测到的SCLC的特征,NLST是一项针对肺癌高危个体的随机试验,比较LDCT和胸片。如果筛查阳性诊断≤1年或较长时间>1年后但诊断手术之间无时间间隔,则SCLC表示为筛查检测到的。如果筛查阴性、诊断≤1年,则为间隔检测到的;如果受试者没有接收任何筛查或其他作为后期筛查,则为非筛查检测到的。

共确诊143例SCLC,其中49例(34.2%)为筛查检测到的,15例(10.5%)为间隔检测到的,79例(55.2%)为非筛查/筛查后。在筛查阶段诊断的病例中(即,筛查检测到或间隔检测到),与NSCLC相比,更多的SCLC是间隔检测到的(23%vs. 5%;p<0.0001)。与NSCLC病例相比,更多的SCLC是晚期(III/IV:86%vs. 36%;p<0.0001)。筛查检测到的(80%III/IV期)、间隔检测到的(86%)和非筛查/后筛查(90%)的SCLC分期均不利。在筛查检测到的SCLC中,仅有63.3%的患者在癌症叶中有≥1个非钙化结节,而NSCLC为85.4%(p<0.0001)。即使是LDCT筛查检测到的很小结节,大部分的SCLC也是晚期的。筛查检测到的SCLC和间隔或后筛查SCLC的生存率无差异。

LDCT的"早期检测"对SCLC预后没有影响。理想情况下,成功的筛查方式应该比在LDCT上检测到SCLC更早。

原始出处:

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    2019-02-05 Smile2680
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    2018-08-13 执迷不悔

    学习了

    0

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    2018-08-08 衣带渐宽

    学习

    0

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    2018-08-06 明月清辉

    谢谢分享,学习了

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