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首页> 外文期刊>Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer >Prediction of true positive lung cancers in individuals with abnormal suspicious chest radiographs: a prostate, lung, colorectal, and ovarian cancer screening trial study.
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Prediction of true positive lung cancers in individuals with abnormal suspicious chest radiographs: a prostate, lung, colorectal, and ovarian cancer screening trial study.

机译：具有可疑胸部X光片异常的个体中真实阳性肺癌的预测：前列腺癌，肺癌，结肠直肠癌和卵巢癌筛查试验研究。

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INTRODUCTION: Chest radiographs are routinely employed in clinical practice. Radiographic findings that are abnormal suspicious (AS) for lung cancer occur commonly. The majority of AS radiographic abnormalities are not cancer. This study identifies predictors of true positive (TP) AS and presents models for estimating the probability of lung cancer. METHODS: This is a prospective cohort study nested in the randomized National Cancer Institute's Prostate Lung Colorectal Ovarian Cancer Screening Trial (PLCO). First-time AS screens in the screening arm of the PLCO were studied. Associations between nonradiographic and radiographic factors, and TP AS were evaluated by multiple logistic regression. RESULTS: The PLCO intervention arm had 77,465 individuals, of whom 12,314 were AS and of these 232 (1.9%) had lung cancer (were TP). Important independent predictors of TP were older age, lower education, greater pack years and duration smoking history, body mass index <30, family history of lung cancer, lung nodule, lung mass, unilateral mediastinal or hilar lymphadenopathy, lung infiltrate, and upper/middle chest AS location. The model including these variables had a receiver operator characteristic area under the curve (ROC AUC) of 86.4%. This model excluding the smoking variables had an ROC AUC of 77.1% and excluding all nonradiographic variables had an ROC AUC of 73.3% (p < 0.0001 for all these model differences). Smoking and nonsmoking nonradiographic variables significantly added to prediction. CONCLUSION: This study identifies important nonradiographic and radiographic predictors of lung cancer, and presents an accurate model for estimating the probability of lung cancer in individuals with suspicious radiographs. These findings may be of value for screening, research, and patient and clinician decision-making.
机译：简介：胸部X光片通常在临床实践中使用。肺癌的异常可疑（AS）影像学发现通常会发生。大多数AS放射学异常不是癌症。这项研究确定了真正阳性（TP）AS的预测因素，并提出了估计肺癌可能性的模型。方法：这是一项前瞻性队列研究，其嵌套在美国国家癌症研究所的前列腺肺大肠直肠卵巢癌筛查试验（PLCO）中。研究了PLCO筛选部门的首次AS筛选。非放射线和放射线照相因素与TP AS之间的关联通过多重logistic回归进行评估。结果：PLCO干预组有77,465人，其中AS为12,314，其中232人（占1.9％）患有肺癌（TP）。 TP的重要独立预测因素是年龄大，文化程度低，大包装年数和吸烟时间长，体重指数<30，肺癌的家族史，肺结节，肺质量，单侧纵隔或肺门淋巴结肿大，肺浸润和上/胸部中部AS位置。包含这些变量的模型在曲线下的接收器操作员特征区域（ROC AUC）为86.4％。排除吸烟变量的该模型的ROC AUC为77.1％，排除所有非放射线变量的ROC AUC为73.3％（对于所有这些模型差异，p <0.0001）。吸烟和非吸烟非放射线变量显着增加了预测。结论：这项研究确定了重要的非放射学和放射学预测肺癌的指标，并提出了一个准确的模型，以估计可疑放射照相个体中肺癌的可能性。这些发现可能对筛查，研究以及患者和临床医生的决策具有价值。

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