Melamed M R, Flehinger B J, Zaman M B
Surg Clin North Am. 1987 Oct;67(5):909-24. doi: 10.1016/s0039-6109(16)44329-x.
The Memorial Sloan-Kettering Lung Cancer Detection Program is described, and data from this study are reported and analyzed. The program enrolled 10,040 cigarette-smoking men who were screened for at least 5 years by annual chest radiographs; half the men randomly selected also had 4-monthly sputum cytologic examinations. Of the 354 lung cancers that developed in these men during the screening period and a 2-year post-screening period, nearly half were adenocarcinomas and nearly one third were epidermoid (or squamous) carcinomas. Lung cancers detected by screening were more likely to be early stage (53 per cent) and resectable (65 per cent) than were those discovered by other means (for example, symptoms) or in the post-screening period (20 per cent early stage, 32 per cent resectable). Sputum cytology was most effective in detecting squamous carcinomas early; chest radiographs were most effective for detecting adenocarcinoma. However, sputum cytology did not reduce lung cancer mortality among these men who were in a program of annual chest radiographic examinations. Overall 5-year survival for all of the men who developed lung cancer was 35 per cent, compared with the national average of 13 per cent.
介绍了纪念斯隆凯特琳肺癌检测项目，并报告和分析了该研究的数据。该项目招募了10040名吸烟男性，通过每年的胸部X光片对他们进行了至少5年的筛查；随机选择的一半男性还每4个月进行一次痰细胞学检查。在这些男性筛查期间及筛查后2年中发生的354例肺癌中，近一半为腺癌，近三分之一为表皮样（或鳞状）癌。与通过其他方式（如症状）发现的肺癌或在筛查后阶段发现的肺癌相比（20%为早期，32%可切除），通过筛查发现的肺癌更可能处于早期阶段（53%）且可切除（65%）。痰细胞学检查在早期检测鳞状癌方面最有效；胸部X光片在检测腺癌方面最有效。然而，在这些每年进行胸部X光检查的男性中，痰细胞学检查并未降低肺癌死亡率。所有患肺癌男性的总体5年生存率为35%，而全国平均水平为13%。
