% 0期刊文章%安东Schreuder %科林·雅各布斯% Lessmann %的派遣一个麦勒J.M. Broeders %一个马里奥席尔瓦%伊凡娜Išgum %一个Pim A·德容%一个Nicola Sverzellati % Mathias h神%尤格Pastorino %一科妮莉亚m . Schaefer-Prokop % Bram van Ginneken % T结合肺和心脏电脑断层生物标志物对特定疾病风险模型在肺癌筛查% D J 2021% R 10.1183/13993003.03386 -2020%欧洲呼吸杂志X % P 2003386 % V 58% N 3%目标的评估心血管疾病(CVD)相结合,COPD和肺癌可能改善吸烟者的肺癌筛查的有效性。目的是获取和评估风险模型预测肺癌发病率,心血管疾病死亡率和慢性阻塞性肺病死亡率结合定量计算机断层扫描(CT)从每个疾病的措施,并量化自我报告的病人增加了预测的好处给CT扫描的可用性特征。方法调查模型(病人)特点,CT模型信息(CT)和最终模型(所有变量)派生为每个示例使用简洁的Cox回归结果从国家肺筛查试验(15 n = 000)。验证了使用多中心意大利肺检测数据(n = 2287)。时间模型歧视和校准报告的措施。结果年龄、平均肺密度,肺气肿,支气管壁厚和主动脉钙量是导致所有最终模型的变量。对肺结节的特征是至关重要的癌症发病率的预测但没有导致心血管疾病和慢性阻塞性肺病死亡率的预测。推导队列,肺癌发病率CT模型有一个5年接受者操作特征曲线下面积的82.5% (95% CI 80.9 - -84.0%),显著低于最终的模型(84.0%,-85.5% - 82.6)。然而,增加病人的特点没有提高肺癌发病率模型性能的验证队列(CT模型80.1%,74.2 - -86.0%;最终模型79.9%,73.9 - -85.8%)。同样,最后CVD死亡率模型优于其他两个模型推导队列(调查模型74.9% 72.7 - -77.1%; CT model 76.3%, 74.1–78.5%; final model 79.1%, 77.0–81.2%), but not the validation cohort (survey model 74.8%, 62.2–87.5%; CT model 72.1%, 61.1–83.2%; final model 72.2%, 60.4–84.0%). Combining patient characteristics and CT measures provided the largest increase in accuracy for the COPD mortality final model (92.3%, 90.1–94.5%) compared to either other model individually (survey model 87.5%, 84.3–90.6%; CT model 87.9%, 84.8–91.0%), but no external validation was performed due to a very low event frequency.Conclusions CT measures of CVD and COPD provides small but reproducible improvements to nodule-based lung cancer risk prediction accuracy from 3 years onwards. Self-reported patient characteristics may not be of added predictive value when CT information is available.Quantitative computed tomography measures of cardiovascular disease and COPD may provide small but reproducible improvements to lung cancer risk prediction accuracy in a screening setting https://bit.ly/3sWyUMM %U //www.qdcxjkg.com/content/erj/58/3/2003386.full.pdf