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[奥地利放射学会和奥地利肺病学会的意见]

[Opinion of the Austrian Society of Radiology and the Austrian Society of Pneumology].

作者信息

Prosch Helmut, Studnicka Michael, Eisenhuber Edith, Olschewski Horst, Stiefsohn Elisabeth, Hartl Sylvia, Herold Christian, Burghuber Otto, Mostbeck Gerhard

机构信息

Universitätsklinik für Radiodiagnostik, Medizinische Universität Wien, Wien, Österreich.

出版信息

Wien Klin Wochenschr. 2013 Jun;125(11-12):339-45. doi: 10.1007/s00508-013-0356-9. Epub 2013 May 15.

Abstract

The National Lung Screening Trial (NLST) could demonstrate, for the first time, in a prospective randomized trial, that low-dose CT screening (LD-CT) may decrease lung cancer mortality. At the moment, it is unclear how these results will be applicable to Austria. Specifically, the definition of the population at an increased risk for lung cancer and management of the high rate of false-positive results are problematic. As a consequence, lung cancer screening in Austria is recommended following the guidelines of the Austrian Society of Radiology and the Austrian Society of Pneumology. The recommendations suggest that only individuals with a significantly increased risk for lung cancer should be screened (age > 55 years, 30 pack-years, active or former smokers since < 15 years). The screened individuals must be informed about the high probability of false-positive screening results and the necessity for additional follow-up examinations or invasive examinations. The screened individuals must be informed that a CT screening may not prevent them from developing an inoperable lung cancer. In addition, CT screening examinations should be performed with a low-dose CT technique for at least three years at yearly intervals. In view of the high probability of false-positive findings, the evaluation of detected pulmonary nodules should be performed according to an already established standardized protocol.

摘要

国家肺癌筛查试验(NLST)首次在一项前瞻性随机试验中证明,低剂量CT筛查(LD-CT)可能降低肺癌死亡率。目前,尚不清楚这些结果如何适用于奥地利。具体而言,肺癌风险增加人群的定义以及高假阳性率结果的处理存在问题。因此,奥地利建议按照奥地利放射学会和奥地利肺病学会的指南进行肺癌筛查。这些建议表明,仅应对肺癌风险显著增加的个体进行筛查(年龄>55岁,吸烟史30包年,过去15年内为现吸烟者或曾吸烟者)。必须告知被筛查个体假阳性筛查结果的高概率以及进行额外随访检查或侵入性检查的必要性。必须告知被筛查个体,CT筛查可能无法防止他们患上无法手术的肺癌。此外,CT筛查检查应采用低剂量CT技术,每年进行一次,至少持续三年。鉴于假阳性结果的高概率,应根据已建立的标准化方案对检测到的肺结节进行评估。

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