Molecular Medicine Program, Department of Experimental Oncology, European Institute of Oncology, Milan, Italy (FM, FD, ED, RMC, GB, PPDF, FB); Center for Genomic Science of IIT@SEMM, Istituto Italiano di Tecnologia, 20139 Milan, Italy (MJM, FN); Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy (ED, PM); IFOM, The FIRC Institute for Molecular Oncology Foundation, Milan, Italy (RMC, PPDF); Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy (RB, LS, GV); Division of Radiology, European Institute of Oncology, Milan, Italy (MB, CR); Department of Scienze della Salute, University of Milan, Milan, Italy (MB, LS, PPDF).
J Natl Cancer Inst. 2015 Mar 19;107(6):djv063. doi: 10.1093/jnci/djv063. Print 2015 Jun.
Lung cancer is the leading cause of cancer death worldwide. Low-dose computed tomography screening (LDCT) was recently shown to anticipate the time of diagnosis, thus reducing lung cancer mortality. However, concerns persist about the feasibility and costs of large-scale LDCT programs. Such concerns may be addressed by clearly defining the target "high-risk" population that needs to be screened by LDCT. We recently identified a serum microRNA signature (the miR-Test) that could identify the optimal target population. Here, we performed a large-scale validation study of the miR-Test in high-risk individuals (n = 1115) enrolled in the Continuous Observation of Smoking Subjects (COSMOS) lung cancer screening program. The overall accuracy, sensitivity, and specificity of the miR-Test are 74.9% (95% confidence interval [CI] = 72.2% to 77.6%), 77.8% (95% CI = 64.2% to 91.4%), and 74.8% (95% CI = 72.1% to 77.5%), respectively; the area under the curve is 0.85 (95% CI = 0.78 to 0.92). These results argue that the miR-Test might represent a useful tool for lung cancer screening in high-risk individuals.
肺癌是全球癌症死亡的主要原因。最近的研究表明，低剂量计算机断层扫描筛查（LDCT）可以预测诊断时间，从而降低肺癌死亡率。然而，人们仍然对大规模 LDCT 计划的可行性和成本存在担忧。通过明确界定需要 LDCT 筛查的目标“高危”人群，可以解决这些担忧。我们最近确定了一个血清 microRNA 特征（miR-Test），可以识别最佳的目标人群。在这里，我们对连续观察吸烟人群（COSMOS）肺癌筛查计划中纳入的高危人群（n = 1115）进行了 miR-Test 的大规模验证研究。miR-Test 的整体准确性、敏感性和特异性分别为 74.9%（95%置信区间 [CI] = 72.2%至 77.6%）、77.8%（95% CI = 64.2%至 91.4%）和 74.8%（95% CI = 72.1%至 77.5%）；曲线下面积为 0.85（95% CI = 0.78 至 0.92）。这些结果表明，miR-Test 可能是高危人群肺癌筛查的有用工具。
