Coimbra University Hospital, Pulmonology Department - Coimbra, Portugal.
Rev Assoc Med Bras (1992). 2022 Apr;68(4):502-506. doi: 10.1590/1806-9282.20211106.
The NELSON study demonstrated a positive association between computed tomography scanning and reduced mortality associated with lung cancer. The COPD-LUCSS-DLCO is a tool designed to improve screening selection criteria of lung cancer for chronic obstructive pulmonary disease patients. The aim of this study was to examine and compare the discriminating value of both scores in a community-based cohort of chronic obstructive pulmonary disease patients.
A retrospective study of chronic obstructive pulmonary disease patients followed in pulmonology consultation for a period of 10 years (2009-2019) was conducted. The NELSON criteria and COPD-LUCSS-DLCO score were calculated for each patient at the time of the study inclusion. The lung cancer incidence was calculated for each of the subgroups during the follow-up period.
A total of 103 patients were included in the study (mean age 64.7±9.2 years, 88.3% male). Applying the COPD-LUCSS-DLCO score, high-risk patients have a 5.9-fold greater risk of developing lung cancer versus the low risk. In contrast, there was no significant association between NELSON selection criteria and lung cancer incidence. The area under the curve was 0.69 for COPD-LUCSS-DLCO and 0.59 for NELSON criteria. Comparing test results showed no differences.
The use of the COPD-LUCSS-DLCO score in clinical practice can help to detect chronic obstructive pulmonary disease patients in greater risk of developing lung cancer with better performance than NELSON criteria. Therefore, models that include a risk biomarker strategy can improve selection criteria and consequently can enhance a better lung cancer prediction.
NELSON 研究表明，计算机断层扫描与肺癌相关死亡率降低之间存在正相关。COPD-LUCSS-DLCO 是一种旨在改善慢性阻塞性肺疾病患者肺癌筛查选择标准的工具。本研究的目的是检查和比较这两个评分在基于社区的慢性阻塞性肺疾病患者队列中的鉴别价值。
对在肺病咨询中随访 10 年（2009-2019 年）的慢性阻塞性肺疾病患者进行回顾性研究。在研究纳入时，为每位患者计算了 NELSON 标准和 COPD-LUCSS-DLCO 评分。在随访期间，计算了每个亚组的肺癌发病率。
共有 103 名患者纳入研究（平均年龄 64.7±9.2 岁，88.3%为男性）。应用 COPD-LUCSS-DLCO 评分，高危患者患肺癌的风险是低危患者的 5.9 倍。相比之下，NELSON 选择标准与肺癌发病率之间没有显著关联。COPD-LUCSS-DLCO 的曲线下面积为 0.69，NELSON 标准为 0.59。比较检验结果显示没有差异。
在临床实践中使用 COPD-LUCSS-DLCO 评分可以帮助检测出患肺癌风险更高的慢性阻塞性肺疾病患者，其性能优于 NELSON 标准。因此，包括风险生物标志物策略的模型可以改善选择标准，从而提高更好的肺癌预测能力。
