Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain; Cancer Center Clinica Universidad de Navarra (CCUN), Pamplona, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.
Pulmonary Department, Clínica Universidad de Navarra, Pamplona, Spain; Cancer Center Clinica Universidad de Navarra (CCUN), Pamplona, Spain.
Arch Bronconeumol. 2024 Feb;60(2):95-100. doi: 10.1016/j.arbres.2023.12.012. Epub 2024 Jan 3.
The Global Initiative for Obstructive Lung Disease (GOLD) recommends lung cancer screening for patients with Chronic Obstructive Pulmonary Disease (COPD), but data is lacking regarding results of screening in this high-risk population. The main goal of the present work is to explore if lung cancer screening with Low Dose Chest Tomography (LDCT) in people with COPD, allows lung cancer (LC) diagnosis in early stages with survival compatible with curative state.
This is a post hoc exploratory analysis. Pamplona International Early Lung Cancer Action Program (P-IELCAP) participants with a GOLD defined obstructive pattern (post bronchodilator FEV/FVC<0.70) were selected for analysis. The characteristics of those who developed LC and their survival are described. A Cox proportional analysis explored the factors associated with LC diagnosis.
Eight hundred and sixty-five patients (77% male, 93% in spirometric GOLD stage 1+2) were followed for 102±63 months. LC prevalence was 2.6% at baseline, with an annual LC diagnosis rate of 0.68%. Early-stage tumors predominated (74%) with a median survival (25-75th percentiles) of 139 (76-185) months. Cumulative tobacco exposure, FEV%, and emphysema were the main predictors of an LC diagnosis. Eight (11%) patients with COPD had a second LC, most of them in early stage (92%), and 6 (8%) had recurrence. Median survival (25-75th percentiles) in these patients was 168 (108-191) months.
Lung cancer screening of selected high-risk participants with COPD allowed the LC diagnosis in early stages with survival compatible with curative state.
全球阻塞性肺病倡议（GOLD）建议对慢性阻塞性肺疾病（COPD）患者进行肺癌筛查，但在高危人群中缺乏关于筛查结果的数据。本研究的主要目的是探讨在 COPD 患者中进行低剂量胸部 CT（LDCT）筛查是否可以早期诊断肺癌（LC），并获得与治愈状态相兼容的生存。
这是一项事后探索性分析。选择 Pamplona 国际早期肺癌行动计划（P-IELCAP）中具有 GOLD 定义的阻塞性模式（支气管扩张剂后 FEV/FVC<0.70）的参与者进行分析。描述了发生 LC 患者的特征及其生存情况。Cox 比例风险分析探讨了与 LC 诊断相关的因素。
865 名患者（77%为男性，93%处于肺功能 GOLD 1+2 期）接受了 102±63 个月的随访。基线时 LC 的患病率为 2.6%，每年 LC 的诊断率为 0.68%。早期肿瘤为主（74%），中位生存时间（25-75 百分位）为 139（76-185）个月。吸烟量、FEV%和肺气肿是 LC 诊断的主要预测因素。8 名（11%）COPD 患者发生了第二例 LC，其中大多数为早期（92%），6 例（8%）复发。这些患者的中位生存时间（25-75 百分位）为 168（108-191）个月。
对选定的高危 COPD 参与者进行肺癌筛查可以早期诊断 LC，并获得与治愈状态相兼容的生存。
