本文選題：假陽性結(jié)果 + 篩查試驗�。� 參考：《中國全科醫(yī)學(xué)》2011年11期

【摘要】：背景直面消費者推薦做肺癌篩查有所增長,尤其低劑量CT。然而,對健康者篩查暴露潛在損害以及低劑量CT累計假陽性率從未有過正式報告。目的對參加1年或2年肺癌篩查至少有1次假陽性結(jié)果的累積風(fēng)險及不必要的診斷性檢查率進(jìn)行量化。設(shè)計低劑量CT與胸部X線隨機對照試驗。設(shè)施國家肺癌篩查試驗的可行性研究。病人為現(xiàn)或曾吸煙者,年齡55～74歲,≥30包/年吸煙史,無肺癌史(n=3 190)。干預(yù)隨機納入低劑量CT組和胸部X線組,重復(fù)1次年度篩查;最后篩查后跟蹤1年。根據(jù)被檢者的年齡、性別和研究中心進(jìn)行中心分層隨機化。測量所定義的假陽性篩查:篩查陽性,而檢驗結(jié)果陰性或跟蹤≥12個月未做出肺癌診斷。結(jié)果用Kaplan-Meier分析法,被檢者低劑量CT檢查1次或更多次假陽性結(jié)果的累積率,1次篩查后為21%〔95%CI(19%,3%)〕,2次篩查后為33%〔95%CI(31%,35%)〕。胸部X線檢查的假陽性結(jié)果累計率分別為9%〔95%CI(8%,11%)〕和15%〔95%CI(13%,16%)〕。總計,低劑量CT檢查假陽性者中有7%和胸部X線檢查假陽性者中有4%做了侵入性手術(shù)。有限性限于2回合篩查。二次篩查后跟蹤限于12個月。有可能忽視了假陰性率。結(jié)論僅經(jīng)2個年度篩查后,尤其是低劑量CT,肺癌篩查假陽性結(jié)果就存在著客觀的風(fēng)險。這些方法導(dǎo)致的經(jīng)濟(jì)、心理社會和身體負(fù)擔(dān),還需做進(jìn)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，

本文編號：2016718