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【文摘发布】低剂量螺旋CT在区分非钙化肺癌淋巴
Chest. 2007 Apr;131(4):1028-34.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17426206&itool=iconabstr&query_hl=1&itool=pubmed_docsum
STUDY OBJECTIVES: Low-dose helical CT scanning identifies early stage lung malignancies and also a large proportion of lung nodules of uncertain diagnostic and prognostic significance (ie, indeterminate nodules). The sensitivity, specificity, and predictive value of these indeterminate nodules detected by CT scanning as part of a lung cancer screening program is largely unknown. We therefore calculated the sensitivity, specificity, and predictive values of CT-detected lung nodules that were followed up at least 18 months. DESIGN: Single-arm screening trial with longitudinal follow-up. SETTING: Rural areas of United States, from 2000 to 2004. PARTICIPANTS: Former and current nuclear weapons workers, >/= 45 years old, including smokers and never-smokers, with variable exposure to occupational lung carcinogens. INTERVENTIONS: A total of 4,401 participants were CT scanned for lung cancer with an initial full chest low-dose CT scan, interval CT scans at 3, 6, and 12 months for indeterminate lung nodules (eg, nodules not immediately suspicious for lung cancer), and a 18-month, full-chest, low-dose incidence CT scan. RESULTS: We achieved follow-up for a minimum of 18 months for > 95% of 807 participants with indeterminate or suspicious lung nodules. Only 3 of 727 indeterminate nodules were identified as being malignant during the subsequent 18 months. The radiologist's designation of a nodule as suspicious had a sensitivity of 84.2% and a specificity of 96.6%. Given a prior probability of lung cancer of 2.4%, positive and negative predictive values were 37.2% and 99.6%. Overall, we detected 33 primary lung cancers, including 19 stage I cancers, 5 stage II cancers, 7 stage III-IV cancers, and 3 limited-stage small cell cancers. CONCLUSIONS: Helical CT scanning detects many indeterminate nodules, but few are malignant. CT scanning has high sensitivity and specificity to detect early lung cancer. The problem of false-positive results in helical CT scanning is limited and can be rationally managed. Current CT follow-up recommendations are supported. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领 初译
Ability of Low-Dose Helical CT To Distinguish Between Benign and Malignant Noncalcified Lung Nodules. 低剂量螺旋CT鉴别非钙化肺癌淋巴结良恶性的能力 初译
Ability of Low-Dose Helical CT To Distinguish Between Benign and Malignant Noncalcified Lung Nodules. 低剂量螺旋CT鉴别非钙化肺癌淋巴结良恶性的能力 STUDY OBJECTIVES: Low-dose helical CT scanning identifies early stage lung malignancies and also a large proportion of lung nodules of uncertain diagnostic and prognostic significance (ie, indeterminate nodules). The sensitivity, specificity, and predictive value of these indeterminate nodules detected by CT scanning as part of a lung cancer screening program is largely unknown. We therefore calculated the sensitivity, specificity, and predictive values of CT-detected lung nodules that were followed up at least 18 months.
研究目的：低剂量CT扫描可鉴别早期肺恶性肿瘤及未明确诊断和预后意义的大范围肺部淋巴结（即不确定淋巴结）。CT扫描检测这些不确定淋巴结的灵敏度，特异性及预测值作为肺癌筛选程序的一部分很大程度上仍未知。因此我们通过随访至少18个月计算CT检测肺癌淋巴结的灵敏度，特异性以及预测值。
更改为：
研究目的：低剂量螺旋CT扫描可确定早期肺恶性肿瘤以及大多数无明确诊断和预后意义的肺部结节（即不确定结节）。作为肺癌筛查计划的一部分，CT扫描检查这些不确定结节的敏感性、特异性和预测值很大程度上尚未清楚。因此，通过随访至少18个月，我们计算了CT检测肺癌结节的灵敏度，特异性以及预测值。
interval CT scans at 3, 6, and 12 months for indeterminate lung nodules
在间隔的3,6,12月行CT扫描检测不确定肺淋巴结
更改为：
对未明确性质的肺结节在检查后的第3、6、12个月行CT扫描
RESULTS: We achieved follow-up for a minimum of 18 months for > 95% of 807 participants with indeterminate or suspicious lung nodules. Only 3 of 727 indeterminate nodules were identified as being malignant during the subsequent 18 months. The radiologist's designation of a nodule as suspicious had a sensitivity of 84.2% and a specificity of 96.6%. Given a prior probability of lung cancer of 2.4%, positive and negative predictive values were 37.2% and 99.6%.
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作者:admin@医学,生命科学 2010-10-20 20:10
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