RT期刊文章SR电子T1序列筛查肺癌高危人群:随机对照试验摩根富林明欧洲呼吸杂志乔和J FD欧元欧洲呼吸学会SP 1900581 10.1183/13993003.00581 -2019签证官54是4 A1斯蒂芬·斯皮罗A1 Pallav l .沙A1罗伯特·c·Rintoul A1杰里米·乔治A1塞缪尔·琼斯A1马修其A1马可Novelli A188bet官网地址1分钱肖A1 Gabrijela Kocjan A1克里斯·格里菲思A1玛丽Falzon A1理查德Booton A1尼古拉斯·麦基A1迈克尔·皮克A1保罗Dhillon A1基肖尔曾经A1安德鲁·g·尼科尔森A1西蒙Padley A1 Magali n .泰勒A1亚洲Ahmed A1杰克艾伦A1严特Ngai A1 Nyasha Chinyanganya A1维多利亚Ashford-Turner A1莎拉·刘易斯A1 Dahmane Oukrif A1帕梅拉·洛夫A1尼古拉斯Counsell A1艾伦Hackshaw年2019 UL //www.qdcxjkg.com/content/54/4/1900581.abstract AB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。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2007 - 2011年期间1568名参与者被随机从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。42 54.8%(23)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 - -1.95)或0.82 (95% CI 0.52 - -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