医学
列线图
前瞻性队列研究
肺癌筛查
危险系数
入射(几何)
内科学
肺癌
食管癌
螺旋CT
队列
人口
癌症
肿瘤科
外科
计算机断层摄影术
置信区间
物理
环境卫生
光学
作者
Huang Xiao,Shi Z,Yan-Hua Zou,Ke-Kui Xu,Xiaoping Yu,Wen Li,Yang Liu,Haiyan Chen,Huajun Long,Jihuai Chen,Yanling Liu,Shiyu Cao,Can Li,Yingyun Hu,Xianzhen Liao,Shipeng Yan
出处
期刊:Lung Cancer
[Elsevier]
日期:2023-03-01
卷期号:177: 1-10
被引量:5
标识
DOI:10.1016/j.lungcan.2023.01.005
摘要
To improve the early stage diagnosis and reduce the lung cancer (LC) mortality for positive nodule (PN) population, data on effectiveness of PN detection using one-off low-dose spiral computed tomography (LDCT) screening are needed to improve the PN management protocol. We evaluate the effectiveness of PN detection and developed a nomogram to predict LC risk for PNs.A prospective, community-based cohort study was conducted. We recruited 292,531 eligible candidates during 2012-2018. Individuals at high risk of LC based on risk assessment underwent LDCT screening and were divided into PN and non-PN groups. The effectiveness of PN detection was evaluated in LC incidence, mortality, and all-cause mortality. We performed subgroup analysis of characteristic variables for the association between PN and LC risk. A competing risk model was used to develop the nomogram.Participants (n = 14901) underwent LDCT screening; PNs were detected in 1193 cases (8·0%). After a median follow-up of 6·1 years, 193 were diagnosed with LC (1·3%). Of these, 94 were in the PN group (8·0%). LC incidence, mortality, and all-cause mortality were significantly higher in the PN group (adjusted hazard ratios: 10.60 (7.91-14.20), 7.97 (5.20-12.20), and 1.94 (1.51-2.50), respectively). Additionally, various PN characteristics were associated with an increased probability of developing LC. The C-index value of the nomogram for predicting LC risk of PN individuals was 0·847.The protocol of PNs management for improvement could focus on specific characteristic population and high-risk PN individuals by nomogram assessment.
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