Melamed M R, Flehinger B J, Zaman M B, Heelan R T, Perchick W A, Martini N
Chest. 1984 Jul;86(1):44-53. doi: 10.1378/chest.86.1.44.
The Memorial Sloan-Kettering lung cancer screening program was begun in 1974 to evaluate sputum cytology as a supplement to the annual chest x-ray examination for early detection and diagnosis. The 10,040 adult, male cigarette smokers who enrolled were randomly assigned to receive annual chest x-ray examinations only or a dual screen with annual chest x-ray examination and four monthly sputum cytology evaluation. Over 40 percent of the 288 who developed lung cancer were diagnosed in stage I, and their survival was 76 percent at five years; overall survival was 35 percent. Nearly one third of the lung cancers detected on first examination on the dual screen, and 14 percent of those on subsequent examinations were found by cytologic examination. The same number of cancers developed in the x-ray screen only group, and were diagnosed at a later date. Despite the delay, survival and mortality were the same, suggesting that the squamous carcinomas detected by cytologic examination alone are very slow growing and tend to remain localized until detectable by x-ray examination.
纪念斯隆-凯特琳癌症中心的肺癌筛查项目始于1974年，旨在评估痰细胞学检查作为年度胸部X光检查的补充手段，用于早期检测和诊断肺癌。10040名成年男性吸烟者参与了该项目，他们被随机分配，一组仅接受年度胸部X光检查，另一组则接受年度胸部X光检查和每月一次的痰细胞学检查的双重筛查。在288名患肺癌的参与者中，超过40%的患者在I期被诊断出，他们的五年生存率为76%；总体生存率为35%。在双重筛查的首次检查中，近三分之一的肺癌是通过细胞学检查发现的，在后续检查中这一比例为14%。仅接受X光筛查的组中也有相同数量的癌症发生，但诊断时间较晚。尽管有延迟，但生存率和死亡率相同，这表明仅通过细胞学检查发现的鳞状细胞癌生长非常缓慢，在通过X光检查可检测到之前往往局限于局部。
