@article {Spiro1900581作者={斯蒂芬·斯皮罗Pallav l·沙阿和罗伯特·c·Rintoul杰里米·乔治和塞缪尔·琼斯和马修其马可Novelli和彭妮肖Gabrijela Kocjan和克里斯·格里菲斯和玛丽Falzon和理查德Booton尼古拉斯·麦基和迈克尔·皮克和保罗Dhillon基肖尔曾经和安德鲁·g·尼科尔森和西蒙Padley Magali n .泰勒和亚洲艾哈迈德和杰克和艾伦和严特耐Nyasha Chinyanganya和维多利亚Ashford-Turner和萨拉·刘易斯和Dahmane Oukrif帕梅拉•洛夫和尼古拉斯Counsell艾伦Hackshaw}, title ={连续筛查肺癌高危人群:随机对照试验},体积= {54}= {4},elocation-id = {1900581} = {2019}, doi ={10.1183/13993003.00581 -2019},出版商={欧洲呼吸学会},文摘={背景低剂量计算机断层扫描(LDCT)筛查检测早期肺癌,降低死亡率。188bet官网地址我们提出了一个连续的方法针对高危人群作为潜在的高效筛选策略。方法LungSEARCH全国多中心随机试验。当前/烟轻/中度慢性阻塞性肺疾病(COPD)被分配(1:1)5年的监测。筛选参与者提供年度痰标本细胞学和血细胞计数,如果异常提供年度LDCT和自发荧光支气管镜检查(空军基地)。那些正常的痰提供年度样本。主要终点是肺癌诊断的比例在阶段I / II (nonsmall细胞)或有限的疾病(小细胞)。结果1568名参与者被随机2007 {\ textendash} 2011年从10英国中心。85.2 \ %的筛选提供了足够的基线痰液样本。有42个肺癌筛选785名个人和36肺癌783控制。54.8 \ %(42)23日筛选个人和45.2 \ %(31日)14日与已知的阶段被诊断出患有早期疾病的控制(单边p = 0.24)。相对危险度为1.21 (95 \ % CI 0.75 {\ textendash} 1.95)或0.82 (95 \ % CI 0.52 {\ textendash} 1.31)早期或晚期癌症,分别。 Overall sensitivity for sputum (in those randomised to surveillance) was low (40.5\%) with a cumulative false-positive rate (FPR) of 32.8\%. 55\% of cancers had normal sputum results throughout. Among sputum-positive individuals who had AFB, sensitivity was 45.5\% and cumulative FPR was 39.5\%; the corresponding measures for those who had LDCT were 100\% and 16.1\%, respectively.Conclusions Our sequential strategy, using sputum cytology/cytometry to select high-risk individuals for AFB and LDCT, did not lead to a clear stage shift and did not improve the efficiency of lung cancer screening.While low-dose CT is now preferred for lung cancer screening, our randomised trial of smokers with COPD showed that a proposed sequential policy using sputum testing to select who receives low-dose CT and autofluorescence bronchoscopy was ineffective http://bit.ly/2JZujnx}, issn = {0903-1936}, URL = {//www.qdcxjkg.com/content/54/4/1900581}, eprint = {//www.qdcxjkg.com/content/54/4/1900581.full.pdf}, journal = {European Respiratory Journal} }