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| 1 | Mortality outcomes of low-dose computed tomography screening for lung cancer in urban China:a decision analysis and implications for practice显示文摘Background: Mortality outcomes in trials of low-dose computed tomography(CT) screening for lung cancer are inconsistent. This study aimed to evaluate whether CT screening in urban areas of China could reduce lung cancer mortality and to investigate the factors that associate with the screening effect.Methods: A decision tree model with three scenarios(low-dose CT screening, chest X-ray screening, and no screening) was developed to compare screening results in a simulated Chinese urban cohort(100,000 smokers aged45-80 years). Data of participant characteristics were obtained from national registries and epidemiological surveys for estimating lung cancer prevalence. The selection of other tree variables such as sensitivities and specificities of low-dose CT and chest X-ray screening were based on literature research. Differences in lung cancer mortality(primary outcome), false diagnoses, and deaths due to false diagnosis were calculated. Sensitivity analyses were performed to identify the factors that associate with the screening results and to ascertain worst and optimal screening effects considering possible ranges of the variables.Results: Among the 100,000 subjects, there were 448,541, and 591 lung cancer deaths in the low-dose CT, chest X-ray, and no screening scenarios, respectively(17.2% reduction in low-dose CT screening over chest X-ray screening and 24.2% over no screening). The costs of the two screening scenarios were 9387 and 2497 false diagnoses and 7and 2 deaths due to false diagnosis among the 100,000 persons, respectively. The factors that most influenced death reduction with low-dose CT screening over no screening were lung cancer prevalence in the screened cohort, lowdose CT sensitivity, and proportion of early-stage cancers among low-dose CT detected lung cancers. Considering all possibilities, reduction in deaths(relative numbers) with low-dose CT screening in the worst and optimal cases were16(5.4%) and 288(40.2%) over no screening, respectively.Conclusions: In terms of mortality outcomes, our findings favor conducting low-dose CT screening in urban China.However, approaches to reducing false diagnoses and optimizing important screening conditions such as enrollment criteria for screening are highly needed. | Zixing Wang Wei Han Weiwei Zhang Fang Xue Yuyan Wang Yaoda Hu Lei Wang Chunwu Zhou Yao Huang Shijun Zhao Wei Song Xin Sui Ruihong Shi Jingmei Jiang | 2017 | Chinese Journal of Cancer2017，36，8： | 9 |
| 2 | 中国城市人群低剂量计算机断层扫描筛查肺癌的死亡率结果:决策分析和实践意义显示文摘背景与目的不同低剂量计算机断层扫描(computed tomography,CT)筛查肺癌试验得出的死亡率结果不一致。本研究旨在评价中国城市CT筛查是否能够降低肺癌死亡率,并探讨影响筛查效果的因素。方法建立了3种场景(低剂量CT筛查、胸部X线筛查和无筛查)的决策树模型来比较模拟的中国城市人群(100,000例年龄45–80岁的吸烟者)的筛查结果。从国家登记和流行病学调查中获得了参与者特征数据并估算了肺癌患病比例。根据文献调研选择了低剂量CT和胸部X线筛查的灵敏度和特异度等其他树变量。计算了3种筛查方法间肺癌死亡率(主要结局)、误诊和误诊导致死亡的差异。通过敏感性分析找出了与筛查结果相关的因素,并确定了在变量可能范围内的最差和最优筛查效果。结果 100,000例研究对象中,低剂量CT、胸部X线和无筛查场景分别有448例、541例和591例肺癌死亡(低剂量CT筛查比胸部X线筛查死亡人数减少17.2%,比无筛查减少24.2%)。100,000例研究对象中,2种筛查场景的代价分别为9387例和2497例误诊及7例和2例误诊导致的死亡。低剂量CT筛查比无筛查的死亡数降低,影响最大的因素是筛查人群的肺癌患病比例、低剂量CT的灵敏度和低剂量CT检出肺癌中早期癌的比例。综合了所有可能性,低剂量CT筛查肺癌的死亡人数(相对数)在最坏和最好情况下分别比无筛查降低了16例(5.4%)和288例(40.2%)。结论就死亡率结局而言,我们的研究结果支持在中国城市人群中进行低剂量CT筛查。然而,急需策略来减少误诊和优化纳入标准等重要筛查条件。 | Zixing Wang Wei Han Weiwei Zhang Fang Xue Yuyan Wang Yaoda Hu Lei Wang Chunwu Zhou Yao Huang Shijun Zhao Wei Song Xin Sui Ruihong Shi Jingmei Jiang | 2018 | 癌症2018，37，8： | 3 |
| 3 | Challenges and research opportunities for lung cancer screening in China显示文摘Following publication of the results of the National Lung Screening Trial in the United States,a randomized controlled trial in Italy(ITALUNG)and two simulation studies in China reported similar findings in 2017 favoring lung cancer screening with low-dose computed tomography among smokers.With such advances in lung cancer screening,worldwide interest has gradually shifted from evaluating whether refining lung cancer screening protocols is effective in preventing deaths.However,there are several practical problems to be resolved,including the balance of enroll-ment criteria and cost effectiveness,precise measurements to reduce false positive findings,risk-based optimization of screening frequency,challenges associated with cancer heterogeneity,strategies to combine image screening with novel biomarkers,dynamic monitoring of the natural history of cancer,accurate identification and diagnosis of cases among huge populations,and the impact of tobacco control policy and environment protection.As one in three individuals with lung cancer worldwide resides in China,these questions pose great challenges as well as research opportunities for population screening programs in China. | Zixing Wang Yuyan Wang Yao Huang Fang Xue Wei Han Yaoda Hu Lei Wang Wei Song Jingmei Jiang | 2018 | Cancer Communications2018，38，1： | 3 |
| 4 | Highly selective recognition of adenosine 5′-triphosphate against other nucleosides triphosphate with a luminescent metal-organic framework of [Zn(BDC)(H_2O)_2]_n(BDC = 1,4-benzenedicarboxylate)显示文摘Selective recognition of adenosine 5′-triphosphate(ATP)is of great significance owing to its indispensable functions to organisms.Also,it is a challenging task because other nucleosides triphosphate hold the same triphosphate group and structurally planar bases as ATP.It is known that metal-organic frameworks(MOFs)are a new type of sensing material.In this work,highly selective recognition of ATP against other nucleosides triphosphate is successfully achieved with a luminescent MOF of[Zn(BDC)(H2O)2]n(BDC2=1,4-benzenedicarboxylate).[Zn(BDC)(H2O)2]n dispersed in water shows a remarkable redshift of the emission wavelength upon addition of ATP,while cytidine 5′-triphosphate(CTP),uridine 5′-triphosphate(UTP),and guanosine 5′-triphosphate(GTP),as well as some inorganic anions such as P2O74 or PO43 can’t induce such spectral change as ATP.1H NMR,31P NMR and Raman spectra indicate that both-stacking interactions and the coordination of Zn(II)with adenine and the phosphate group are involved in the interaction of[Zn(BDC)(H2O)2]n with ATP.In addition,the experimental results showed that the redshift extent of the emission wavelength of[Zn(BDC)(H2O)2]n has the linear relationship with the concentration of ATP in the range of 0.3–1.8 mmol/L.Based on this,the detection of ATP content in the sample of ATP injection was made with satisfactory results.This system pioneers the application of MOFs in the recognition of nucleotides,and testifies that the participation of base in the recognition process can improve the selectivity against the other nucleotides. | ZHAO XiJuan FANG JingMei LI YuanFang HUANG ChengZhi | 2013 | Science China Chemistry2013，56，11： | 0 |
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