肺癌发现方式对肿瘤预后的影响：来自KBP-2020-CPHG研究的数据
Impact of lung cancer discovery mode on cancer outcomes: data from the KBP-2020-CPHG study.
作者
作者单位
- Department of Pulmonology and Thoracic Oncology, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France.
- Department of Pulmonology, Groupe Hospitalier Intercommunal Le Raincy Montfermeil, Montfermeil, France.
- Department of Pulmonology Centre Hospitalier Intercommunal Fréjus - Saint-Raphaël, Fréjus, France.
- Department of Pulmonology, Maison de Santé Protestante de Bordeaux-Bagatelle, Talence, France.
- Department of Pulmonology, Robert Schuman Hospital UNEOS, Metz, France.
- Department of Pulmonology, Hospital Center, Toulon, France.
- Department of Pulmonology, Hospital Center Tarbes - Lourdes, Tarbes, France.
- Biostatistician, QualityStat, Morangis, France.
- Department of Pulmonology, GHRMSA, Hospital Émile Muller, Mulhouse, France.
摘要
中文
肺癌是全球癌症相关死亡的主要原因。早期发现显著改善预后，但由于早期症状有限，大多数诊断处于晚期。这项来自KBP-2020-CPHG队列的真实世界研究评估了根据肺癌发现方式的临床特征和总生存期。KBP-2020-CPHG是一项全国性前瞻性队列，包含法国非学术医院8999例新诊断肺癌患者。患者按肺癌发现方式分为症状性表现、偶然发现或个体筛查。比较各组的基线特征和生存期。在8943例有数据的患者中，6404例（71.6%）通过症状诊断，2178例（24.4%）偶然发现，361例（4.0%）通过非组织化背景下的机会性筛查。总体而言，分别有71.0%、82.5%和89.1%的患者体能状态为0/1（p<0.0001），3.4%、6.4%和6.9%患有贴壁状腺癌（p<0.001）。筛查患者中54.6%、偶然诊断患者中40.5%、症状诊断患者中仅10.6%被诊断为早期疾病（0-II期）（p<0.0001）。中位总生存期分别为45.6、30.0和11.5个月。相应的3年总生存率分别为59.0%、46.3%和26.4%。肺癌发现方式与诊断分期和生存期相关。与症状诊断相比，筛查和偶然发现与更早的诊断分期和显著更好的总生存期相关。这些发现支持更广泛地实施结构化早期检测策略，包括筛查计划，以改善肺癌患者的预后。
English
Lung cancer is the leading cause of cancer-related mortality worldwide. Early-stage detection significantly improves prognosis, but most diagnoses are made at advanced stages due to limited early symptoms. This real-world study from the KBP-2020-CPHG cohort evaluated clinical characteristics and overall survival according to the mode of lung cancer discovery. KBP-2020-CPHG is a nationwide prospective cohort of 8999 patients with newly diagnosed lung cancer in non-academic French hospitals. Patients were categorised by mode of lung cancer discovery as symptomatic presentation, incidental finding or individual screening. Baseline characteristics and survival were compared across groups. Among 8943 patients with available data, 6404 (71.6%) were diagnosed symptomatically, 2178 (24.4%) incidentally and 361 (4.0%) through opportunistic screening in a non-organised context. Overall, 71.0%, 82.5% and 89.1% of patients, respectively, had performance status 0/1 (p<0.0001), and 3.4%, 6.4% and 6.9% had lepidic adenocarcinoma (p<0.001). Early-stage disease (stages 0-II) was diagnosed in 54.6% of screened patients, 40.5% of incidentally diagnosed patients and just 10.6% of symptomatically diagnosed patients (p<0.0001). Median overall survival was 45.6, 30.0 and 11.5 months, respectively. Corresponding 3-year overall survival rates were 59.0%, 46.3% and 26.4%. The mode of lung cancer discovery was associated with stage at diagnosis and survival. Compared with symptomatic diagnosis, screening and incidental detection were associated with earlier stage of diagnosis and significantly better overall survival. These findings support the broader implementation of structured early-detection strategies, including screening programs, to improve the prognosis of patients with lung cancer.
分类与指标
- 研究类型
- 临床研究
- 病种
- 肺癌
- JCR 分区
- Q1
- 影响因子
- 4.4
- 新锐分区
- 3区