Table CDR62832 Lung Cancer Screening/肺癌筛查
ID Type Description_en Description_zh
w1 Word Overdiagnosis 过度诊断
p1 Phrase False positive exams 检查假阳性
p2 Phrase Lung Cancer Screening 肺癌筛查
p3 Phrase Lung Cancer (PDQ®): Screening 肺癌(PDQ®):筛查​
p4 Phrase Description of the Evidence 证据说明
p5 Phrase Study Design : Randomized controlled trials 研究设计:随机对照试验
p6 Phrase Evidence of Benefit Associated With Screening 筛查相关获益证据
p7 Phrase Two included sputum cytology as well 两项研究也分析了痰细胞学
p8 Phrase Screening by low-dose helical computed tomography 低剂量螺旋CT筛查
p9 Phrase Evidence of No Benefit Associated With Screening 无筛查获益的证据
p10 Phrase Evidence of no benefit associated with screening 筛查无获益证据
p11 Phrase Screening by chest x-ray and/or sputum cytology 胸部X线检查和(或)痰细胞学
s1 Sentence Consistency : Not applicable—one randomized trial to date 一致性:不适用-目前仅1项随机试验
s2 Sentence No reduction in lung cancer mortality was observed 结果未观察到肺癌死亡率降低
s3 Sentence Overall mortality was reduced by 6.7% (95% CI, 1.2–13.6) 全死因死亡率降低6.7%(95%CI,1.2-13.6)
s4 Sentence Tobacco use, second hand smoke, and other risk factors 吸烟、二手烟及其它危险因素
s5 Sentence LDCT was shown to be more sensitive than chest radiography LDCT比胸部X线片更敏感
s6 Sentence Sub-analyses suggested no differential effect by sex or smoking status 亚组分析显示性别或吸烟情况无差异化效应
s7 Sentence The question of lung cancer screening dates back to the 1950s 关于肺癌筛查的研究可追溯到20世纪50年代
s8 Sentence Neither study observed a reduction in lung cancer mortality with screening 这两项研究均发现筛查并不降低肺癌死亡率
s9 Sentence Environmental or secondhand tobacco smoke is also implicated in causing lung cancer 环境或二手烟接触也是引起肺癌的因素
s10 Sentence Expert-reviewed information summary about tests used to detect or screen for lung cancer 肺癌检出或筛查的专家审核信息摘要
s11 Sentence Other randomized controlled trials of LDCT are under way in a number of countries 其它有关LDCT的随机对照试验目前正在很多国家进行
s12 Sentence Eight observational studies of LDCT in various parts of the world have been reported and summarized 世界各地共报道8项LDCT的观察性研究
s13 Sentence The ELCAP screening protocol was applied in 1,119 asbestos-exposed people whose average age was 57 years 对1,119例平均年龄为57岁,有砷暴露史的受检者实施ELCAP筛查方案
s14 Sentence Twenty-five biopsies resulted in the detection of one stage IA and four late stage lung cancers 共25例患者行活检,发现1例IA期、4例晚期肺癌患者
s15 Sentence The most important risk factor for lung cancer (as for many other cancers) is tobacco use 吸烟是肺癌(及其它很多癌症)的最重要的危险因素
s16 Sentence The design of the Mayo Clinic study (known as the Mayo Lung Project, or MLP), was different Mayo诊所研究(即梅奥肺计划, MLP)的设计有所不同
s17 Sentence Most of the studies include a substantial percentage of females, and the studies in Japan include nonsmokers 多数研究的女性参与者比例较高,日本研究中纳入非吸烟者
s18 Sentence In the Irish study (N = 449), however, the prevalence of cancers detected was substantially smaller (0.46%) 但该研究(N=449)中,癌症检出率明显低于ELCAP的结果(0.46%)
s19 Sentence However, eight patients had surgery for benign lesions, five of which appeared to grow on follow-up CT 8例患者手术后结果提示为良性,其中5例患者的随访CT显示病变增大
s20 Sentence Updated statistics with estimated new cases and deaths for 2014 (cited American Cancer Society as reference 1) 更新2014年新发病例与死亡病例的统计学​数据(引用美国癌症研究所参考文献1)
s21 Sentence Five studies of chest imaging, two of which were controlled, were undertaken during the 1950s and 1960s 20世纪50、60年代共进行了5项胸部影像的研究,其中2项为对照研究
s22 Sentence False-positive test results and overdiagnosis must be considered when lung cancer screening with LDCT is being evaluated 评估LDCT筛查肺癌时必须考虑到假阳性和过度诊断结果
s23 Sentence The number needed to screen with low-dose CT to prevent one death from lung cancer was 320 每行320次低剂量CT筛查,可预防1例肺癌死亡
s24 Sentence One study was conducted at the Mayo Clinic, one at Johns Hopkins University, and one at Memorial Sloan-Kettering 一项研究在Mayo诊所进行,一项在约翰霍普金斯大学进行,一项在Sloan-Kettering纪念医院进行
s25 Sentence It is not clear whether the detection of these abnormalities produces a net benefit or a net harm 尚不明确检测出这些异常是否有净受益或净危害
s26 Sentence These are relatively small studies, ranging from about 600 to 8,000 participants, which began between 1992 and 2000 这些研究规模相对较小,受检者人数在600-8,000例,研究开始时间在1992-2000年
s27 Sentence Radon, a naturally occurring gas, is of relevance to the general public because of the potential exposure in homes 氡作为一种天然气体,平常居住环境中有潜在暴露的可能,故该危险因素与大众密切相关
s28 Sentence The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH 本概要为独立的文献综述,不作为NCI或NIH的政策声明
s29 Sentence These additional causal factors are primarily related to occupational exposures to agents such as asbestos, arsenic, chromium, nickel, and radon 其他致病因素主要与职业暴露相关,例如石棉、砷、铬、镍、氡
s30 Sentence Cigarette smoking has been definitively established by epidemiologic and preclinical animal experimental data as the primary cause of lung cancer 流行病学调查、临床前动物试验数据均明确证实吸烟是肺癌的主要原因
s31 Sentence The percentages of lung cancers estimated to be caused by tobacco smoking in males and females are 90% and 78%, respectively 据估算,男性和女性中吸烟引起的肺癌百分比分别为90%与78%
s32 Sentence The results of these studies suggested no overall benefit of screening, although design limitations prevented the studies from providing definitive evidence 尽管因研究设计所限而无法提供确切证据,但这些研究的结果提示筛查无总体获益
s33 Sentence Elevated biomarkers of tobacco exposure, including urinary cotinine, tobacco-related carcinogen metabolites, and carcinogen-protein adducts, are seen in passive or secondhand smokers 主动或被动吸烟者中,与烟草暴露相关的生物标志物升高,包括尿尼古丁、香烟相关致癌原代谢物和致癌原-蛋白加合物
s34 Sentence In two other studies, which used 5 mm CT slices, noncalcified nodules were detected in a much higher proportion of patients 另有2项研究使用5mm CT,患者中非钙化结节的检出率较高
s35 Sentence During the first three rounds of screening in the Mayo Clinic study, 696 such abnormalities were found in the 1,520 patients Mayo诊所的研究结果显示,在前三轮筛查中,1,520例患者中共发现696例类似的异常
s36 Sentence There have been intensive efforts to improve lung cancer screening with newer technologies, including low-dose helical computed tomography (LDCT) and molecular techniques 包括低剂量螺旋CT(LDCT)与分子技术等在内的新技术,有效的推进了肺癌的筛查
s37 Sentence The MLP was interpreted in the 1970s as showing no benefit of an intense screening regimen with chest x-ray and sputum cytology 20世纪70年代的MLP研究结果表明胸片加痰细胞学的强化筛查方案并无获益
s38 Sentence The two studies were interpreted as showing no benefit of frequent sputum cytology when added to an annual regimen of chest x-ray 可理解为即使增加每年一次胸片检查,频繁的痰细胞学检查不增加获益
s39 Sentence Carcinogenic compounds in tobacco smoke include the polynuclear aromatic hydrocarbons (PAHs), including the classical carcinogen benzo[a]pyrene and the nicotine-derived tobacco-specific nitrosamine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) 烟草烟雾中的致癌物质包括多核芳烃(PAH),如典型致癌物苯并芘和来自尼古丁香烟特有的亚硝胺4-甲基亚硝胺基-1-3-吡啶基-1-丁酮(NNK)
s40 Sentence The mean proportion of patients with clinically significant incidental findings—defined as any abnormality considered to require additional diagnostic workup—was 14.2% (95% CI, 13.2%–15.2%) 发现有临床意义(即需要进一步诊断)异常的受检者比例为14.2%(95%CI,13.2%-15.2%)
s41 Sentence In addition, screening with LDCT can detect abnormalities other than noncalcified nodules, including enlarged lymph nodes, abdominal aortic aneurysms, and renal and adrenal masses LDCT筛查除能够检出非钙化结节之外,还能够检出如淋巴结肿大、腹主动脉瘤、肾与肾上腺肿物等异常
s42 Sentence Environmental tobacco smoke has the same components as inhaled mainstream smoke, although in lower absolute concentrations; between 1% and 10%, depending on the constituent 尽管绝对含量较少,但环境中的烟草烟雾与吸烟直接吸入的烟雾成分相同,根据成分,其含量约在1%-10%
s43 Sentence In rodents, total doses of both PAH and NNK that are similar to doses received by humans in a lifetime of smoking induce pulmonary tumors 啮齿动物如暴露于等同于人类终生吸烟的PAH与NNK总剂量可诱发肺癌
s44 Sentence The investigators reported 19 lung cancer deaths in the intervention arm and 13 in the control arm, and concluded that frequent screening was not necessary 研究者报道试验组与对照组的肺癌死亡例数分别19例与13例,研究者认为频繁筛查并无必要
s45 Sentence The false-positive test result, which is more common than overdiagnosis, may lead to anxiety and invasive diagnostic procedures such as percutaneous needle biopsy or thoracotomy 假阳性结果比过度诊断更为常见,可能导致受检者焦虑和不必要的有创检查例如经皮细针穿刺活检或开胸探查术
s46 Sentence Ninety-five percent of these nodules were less than 8 mm in diameter, for which the recommended follow-up was noncontrast CT in 3 to 6 months 其中在建议3-6个月非增强CT随访的结节中有95%的结节直径小于8mm
s47 Sentence The authors concluded the screening program was not able to replicate the ELCAP results and was not cost effective for lung cancer screening in this population 由于该筛查并未复现ELCAP的研究结果,因此作者认为对该人群肺癌筛查的成本效益不高
s48 Sentence In the Mayo Clinic study, noncalcified nodules were detected in 51% of 1,520 patients at the prevalence screen and cumulatively in 74% after five subsequent annual screens Mayo诊所对1,520例受检者进行筛查的研究发现,首次筛查后有51%的受检者检出非钙化结节,连续5年年度筛查总计74%患者检出结节
s49 Sentence In the ELCAP study, which used a CT slice thickness of 10 mm, noncalcified nodules were detected in 21% of patients without lung cancer at the prevalence screen ELCAP研究使用的CT层厚为10mm,21%的非肺癌受检者中检出非钙化结节
s50 Sentence In a 2008 systematic review of chest CT lung cancer screening studies, the mean proportion of patients with any incidental abnormality was 65.2% (95% confidence interval [CI], 63.5%–66.9%) 2008年一项胸部CT肺癌筛查研究的系统性评价发现,出现任何异常的受检者平均比例为65.2%(95%置信区间[CI],63.5%-66.9%)
s51 Sentence Many other exposures have been established as causally associated with lung cancer, but even the combined effect of these additional factors is very small compared with cigarette smoking 很多其它暴露因素也与肺癌之间存在因果关系,但这些因素总的影响相比于吸烟而言仍极小
s52 Sentence The lung component of PLCO addressed the question of whether annual single-view (posterior-anterior) chest x-ray was capable of reducing lung cancer mortality as compared with usual medical care PLCO中肺癌筛查部分解答了每年一次单一体位(后前位)胸片较常规医疗相比是否能够降低肺癌死亡率的问题
s53 Sentence All potential participants were screened with chest imaging and sputum cytology, and those known or suspected to have lung cancer, as well as those in poor health, were excluded 所有受检者均行胸片与痰细胞学筛查,研究不纳入已知或怀疑肺癌的患者或身体状况较差的受检者
s54 Sentence This causative link has been widely recognized since the 1960s, when national reports in Great Britain and the United States brought the cancer risk of smoking prominently to the public’s attention 20世纪60年代,英国和美国国家报告使得吸烟——这一癌症危险因素受到了公众的关注,并且得到了广泛的认可
s55 Sentence In a case series that defined the population at high risk of lung cancer by occupations associated with asbestos exposure, 58% accepted an invitation to participate in an LDCT screening program 一项以金属砷暴露定义为肺癌高危的研究中,58%患者愿意参与LDCT筛查
s56 Sentence A study in Ireland, which aimed to reproduce the ELCAP study in high-risk but younger individuals, revealed a similar proportion of noncalcified nodules were detected using 10 mm CT slice thickness 一项在爱尔兰对较年轻的高危受检者中进行的研究中, 参照ELCAP标准,发现使用10 mm层厚CT的非钙化结节检出率与ELCAP相似
s57 Sentence At 13 years of follow-up, 1,213 lung cancer deaths were observed in the intervention group, compared with 1,230 lung cancer deaths in the usual-care group (mortality relative risk, 0.99; 95% CI, 0.87–1.22) 经过13年随访后,试验组共1,213例肺癌死亡病例,常规医疗组1,230例肺癌死亡(死亡率相对风险,0.99;95%CI,0.87-1.22)
s58 Sentence Thirty-one (13%) of 233 individuals with noncalcified nodules underwent biopsies, of which close to 90% (27 of 31 patients) resulted in a diagnosis of malignancy, and the prevalence of cancers detected was 2.7% 233例非钙化结节患者中31例(13%)行活检,其中近90%(27/31例)诊断为恶性,检出率为2.7%
s59 Sentence The program comprised three separate randomized controlled trials, each enrolling about 10,000 male participants aged 45 years and older who smoked at least one pack of cigarettes a day in the previous year 该计划共包括3项独立的随机对照试验,各招募约10,000例年龄≥45岁的男性参与者,这些参与者在过去一年内每天吸烟至少1包
s60 Sentence The Czechoslovakian study began with a prevalence screen (chest imaging and sputum cytology) of 6,364 males aged 40 to 64 years who were current smokers with a lifetime consumption of at least 150,000 cigarettes 一项捷克斯洛伐尼亚研究对6,364例40-64岁男性受检者行患病率筛查(胸片加痰细胞学),这些受检者均有吸烟史,终生吸烟不少于150,000支
s61 Sentence When the study began, all participants randomly assigned to screening were invited to receive a baseline and three annual chest x-ray screens, although the protocol ultimately was changed to screen never-smokers only three times 研究开始时,被随机分入筛选组的所有受检者接受基线筛查后3次年度胸片筛查,但最终研究方案更改为非吸烟者接受3次年度筛查
s62 Sentence In the Early Lung Cancer Action Project (ELCAP), LDCT detected almost six times as many stage I lung cancers as chest radiography, and most of these tumors were no larger than 1 cm in diameter 早期肺癌行动计划(ELCAP)研究显示:LDCT检出的I期肺癌患者数是胸片的6倍,多数肿瘤直径小于25px
s63 Sentence Findings include a nodule or positivity rate of 5% to 51%, 0.4% to 3% lung cancers, 50% to 95% adenocarcinomas, 50% to 91% stage I or IA cancers, and estimates of sensitivity ranging from 40% to 95% 研究结果显示肺结节或阳性率为5%-51%,肺癌检出率为0.4%-3%,腺癌检出率50%-95%,I期或IA期癌症检出率50%-91%,敏感性估值在40%-95%之间
s64 Sentence The Hopkins and Sloan-Kettering studies employed the same design: persons randomly assigned to the intervention arm received sputum cytology every 4 months and annual chest imaging, while persons randomly assigned to the control arm received annual chest imaging Hopkins与Sloan-Kettering研究所用设计相同,即受检者随机分入试验组或对照组,试验组受检者每4个月查一次痰细胞学,每年行一次胸片检查,对照组仅每年行一次胸片检查
s65 Sentence In the radiography group, 279 cancers were diagnosed after a positive screening test, 137 after a negative screening test, and 525 among participants who either missed the screening or received the diagnosis after the completion of the screening phase 胸片组中279例筛查阳性受检者诊断为癌症,137例筛查阴性受检者后被诊断为癌症,未参与筛查或筛查期结束后诊断癌症的受检者共525例
s66 Sentence A total of 356 and 443 deaths from lung cancer occurred in the LDCT and chest x-ray groups, respectively, with a relative reduction in the rate of death from lung cancer of 20.0% (95% CI, 6.8–26.7) with LDCT screening LDCT组与胸片组总计分别有356例患者与443例患者死于肺癌,LDCT组肺癌死亡率相对降低20.0%(95%CI,6.8-26.7)
s67 Sentence In the LDCT group, 649 cancers were diagnosed after a positive screening test, 44 after a negative screening test, and 367 among participants who either missed the screening or received the diagnosis after the completion of the screening phase LDCT组中649例筛查阳性受检者诊断为癌症,44例筛查阴性受检者后被诊断为癌症,未参与筛查或筛查期结束后诊断癌症的受检者共367例
s68 Sentence In the early 1970s, the National Cancer Institute funded the Cooperative Early Lung Cancer Detection Program, which was designed to assess the ability of screening with radiologic chest imaging and sputum cytology to reduce lung cancer mortality in male smokers 在20世纪70年代早期,美国国家癌症研究所就资助了早期肺癌检出合作计划,该计划旨在评估胸片和痰细胞学在降低男性吸烟者的肺癌死亡率的能力
s69 Sentence Furthermore, NLST data are being analyzed to examine other important issues in lung cancer screening, including cost effectiveness, quality of life, and whether screening would benefit individuals younger than those enrolled in NLST and those with fewer than 30 pack-years of smoking exposure 此外,一些研究正在分析NLST数据以了解有关肺癌筛查的其它重要内容,包括成本效益、生活质量及比起NLST中纳入的吸烟量小于30包-年的患者来说,在较年轻患者中进行筛查是否更有益等
s70 Sentence The ability of LDCT to reduce lung cancer mortality was demonstrated in the randomized, controlled National Lung Screening Trial (NLST): a statistically significant relative reduction of 20% in lung cancer mortality was observed, as was a statistically significant 6.7% relative reduction in all-cause mortality 美国国家肺癌筛查试验(NLST)的随机对照试验研究显示LDCT在降低肺癌死亡率中的能力,即:肺癌死亡率相对降低20%,全因死亡率相对降低6.7%,其结果均具统计学意义
s71 Sentence Furthermore, several individuals underwent invasive procedures for ultimately benign conditions (three of four patients with nodules >10 mm who underwent biopsy had benign cytology; one had a thoracotomy that confirmed benign disease; three patients with mediastinal masses underwent biopsy and two had benign cysts) 部分受检者行有创检查,结果为良性(4例结节>10mm行活检,其中3例细胞学为良性,另1例行开胸探查术证实为良性;3例纵隔肿物患者活检,其中2例为良性囊肿)
s72 Sentence Remaining persons were randomly assigned to either an intervention arm that received chest imaging and sputum cytology every 4 months for 6 years, or to a control arm that received a one-time recommendation at trial entry to receive the same tests on an annual basis 余下的研究对象被随机分为两组,干预组每4个月进行一次胸片与痰细胞学联合筛查,对照组则每年进行1次联合筛查,为期均为6年
s73 Sentence All participants except the 18 diagnosed with lung cancer as a result of the prevalence screen were randomly assigned to one of two arms: an intervention arm, which received semi-annual screening for 3 years, or a control arm, which received screening during the third year only 除了18例确诊肺癌的患者之外,所有其余参与者均被随机分入两组:试验组每半年筛查一次持续3年,对照组仅在第3年接受筛查
s74 Sentence Given the abundance and consistency of evidence, as well as the lack of benefit observed in the PLCO trial, it is appropriate to conclude that lung cancer screening with chest x-ray and/or sputum cytology, regardless of sex or smoking status, does not reduce lung cancer mortality 基于当前大量一致证据以及PLCO试验中未观察到获益,可认为胸片和(或)痰细胞学肺癌筛查不降低肺癌死亡率,与性别或吸烟情况无关