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低剂量计算机断层扫描(LDCT)与其他癌症筛查在肺癌早期诊断中的比较:一项荟萃分析。

Low-dose computed tomography (LDCT) versus other cancer screenings in early diagnosis of lung cancer: A meta-analysis.

作者信息

Wang Xiaojing, Liu Hongli, Shen Yuanbing, Li Wei, Chen Yuqing, Wang Hongtao

机构信息

Anhui Clinical and Preclinical Key Laboratory of Respiratory Disease, Department of Respiration Department of Gynecological Oncology, First Affiliated Hospital, Bengbu Medical College, Bengbu Department of Immunology, Research Center of Immunology, Bengbu Medical College, Anhui, P.R. China.

出版信息

Medicine (Baltimore). 2018 Jul;97(27):e11233. doi: 10.1097/MD.0000000000011233.

Abstract

BACKGROUND

Lung cancer is the leading cause of cancer mortality worldwide. It is often diagnosed at an advanced stage when treatment is no longer possible. Early population-based screening may provide an opportunity for early diagnosis and reduce mortality rates.

METHODS

Study characteristics were collected and outcome data (lung cancer diagnosis and mortality) were extracted and used for meta-analysis. Statistical analyses were performed using OpenMetaAnalyst-0.1503 software. The odds ratio (OR) and 95% confidence interval (CI) were used to assess LDCT compared to other screening methods under the random-effects model. The I2 statistic was used to assess heterogeneity.

RESULTS

Pooling data from 4 studies (64,129 patients) showed a higher incidence of diagnosed lung cancer with LDCT screening (OR = 1.86, 95% CI: 1.02-3.37), compared to other screening tools. However, no significant difference (OR = 1.13, 95% CI: 0.78-1.64) was found in lung cancer mortality between both groups.

CONCLUSIONS

Although no significant difference was found between LDCT and other control groups in terms of lung cancer mortality, this meta-analysis suggests an increased diagnosis of lung cancer with LDCT as compared with other screening modalities. This meta-analysis displays the potential but also the limitations of LDCT for early lung cancer detection.

摘要

背景

肺癌是全球癌症死亡的主要原因。它常常在无法进行治疗的晚期阶段才被诊断出来。基于人群的早期筛查可能为早期诊断提供机会并降低死亡率。

方法

收集研究特征,并提取结局数据(肺癌诊断和死亡率)用于荟萃分析。使用OpenMetaAnalyst - 0.1503软件进行统计分析。在随机效应模型下,使用比值比(OR)和95%置信区间(CI)来评估低剂量计算机断层扫描(LDCT)与其他筛查方法相比的情况。I²统计量用于评估异质性。

结果

汇总4项研究(64,129名患者)的数据显示,与其他筛查工具相比,LDCT筛查诊断出肺癌的发生率更高(OR = 1.86,95% CI:1.02 - 3.37)。然而,两组之间在肺癌死亡率方面未发现显著差异(OR = 1.13,95% CI:0.78 - 1.64)。

结论

尽管在肺癌死亡率方面,LDCT与其他对照组之间未发现显著差异,但这项荟萃分析表明,与其他筛查方式相比,LDCT诊断出肺癌的情况有所增加。这项荟萃分析展示了LDCT在早期肺癌检测方面的潜力和局限性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baab/6076107/cb266ced2a54/medi-97-e11233-g003.jpg

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