Department of Critical Care Medicine, Far Eastern Memorial Hospital, New Taipei 22000, Taiwan.
Department of Industrial Engineering and Management, Yuan Ze University, Taoyuan 32003, Taiwan.
Int J Environ Res Public Health. 2022 Apr 12;19(8):4633. doi: 10.3390/ijerph19084633.
Early detection of lung cancer has a higher likelihood of curative treatment and thus improves survival rate. Low-dose computed tomography (LDCT) screening has been shown to be effective for high-risk individuals in several clinical trials, but has high false positive rates. To evaluate the risk of stage I lung cancer in the general population not limited to smokers, a retrospective study of 133 subjects was conducted in a medical center in Taiwan. Regularized regression was used to build the risk prediction model by using LDCT and health examinations. The proposed model selected seven variables related to nodule morphology, counts and location, and ten variables related to blood tests and medical history, achieving an area under the curve (AUC) value of 0.93. The higher the age, white blood cell count (WBC), blood urea nitrogen (BUN), diabetes, gout, chronic obstructive pulmonary disease (COPD), other cancers, and the presence of spiculation, ground-glass opacity (GGO), and part solid nodules, the higher the risk of lung cancer. Subjects with calcification, solid nodules, nodules in the middle lobes, more nodules, and diseases related to thyroid, liver, and digestive systems were at a lower risk. The selected variables did not indicate causation.
早期发现肺癌更有可能进行治愈性治疗，从而提高生存率。低剂量计算机断层扫描（LDCT）筛查已在几项临床试验中证明对高危人群有效，但假阳性率较高。为了评估非吸烟者的一般人群中 I 期肺癌的风险，对台湾一家医疗中心的 133 名受试者进行了回顾性研究。使用 LDCT 和健康检查，通过正则化回归建立风险预测模型。所提出的模型选择了与结节形态、数量和位置相关的七个变量，以及与血液检查和病史相关的十个变量，实现了曲线下面积（AUC）值为 0.93。年龄、白细胞计数（WBC）、血尿素氮（BUN）、糖尿病、痛风、慢性阻塞性肺疾病（COPD）、其他癌症以及存在分叶征、磨玻璃密度（GGO）和部分实性结节的受试者肺癌风险更高。有钙化、实性结节、中叶结节、更多结节以及与甲状腺、肝脏和消化系统疾病相关的受试者肺癌风险较低。选择的变量并不表明存在因果关系。
