Low Dose Computed Tomography for Lung Cancer Screening in Tuberculosis Endemic Countries: A Systematic Review and Meta-Analysis.

Nevertheless, in high tuberculosis-burden countries (HTBC), there are concerns about high false-positive rates due to persistent lung lesions from prior tuberculosis (TB) infections.

然而，在结核病负担高的国家（HTBC），由于既往结核（TB）感染导致的持续性肺部病变，人们担心会有高假阳性率的问题。

This study aims to evaluate the screen-positive rate (SPR) of LDCT screening in HTBC.

本研究旨在评估低剂量计算机断层扫描（LDCT）在高危胸壁结核（HTBC）筛查中的筛查阳性率（SPR）。

Methods

We conducted a systematic reviewand meta-analysisto identify studies utilizing LDCT for LCS in HTBC and reported SPR from inception to December 6, 2023.

我们进行了一项系统综述和荟萃分析，以识别使用LDCT进行HTBC的肺癌筛查（LCS）的研究，并报告了从研究开始至2023年12月6日的筛查阳性率（SPR）。

The primary outcome was the SPR, and the secondary outcome was the lung cancer detection rate (LCDR).

主要结果是SPR（敏感性），次要结果是肺癌检出率（LCDR）。

The summary data was pooled using a random-effects model, and factors influencing the SPR were analyzed using multivariable meta-regression analysis.

使用随机效应模型汇总数据，并使用多变量元回归分析分析影响SPR的因素。

Results

A total of 44 studies with 477,424 individuals (59.3% men) were included in the systematic review.

系统综述共纳入了44项研究，涉及477,424名个体（59.3%为男性）

Lung Imaging Reporting and Data System (Lung-RADS) (31%, 14 studies) and National Lung Screening Trial (NLST) criteria (non-calcified nodule ≥ 4 mm; 10 studies) were the most common criteria used for assessing SPR.

肺部影像报告和数据系统（Lung-RADS）（31%，14项研究）和国家肺癌筛查试验（NLST）标准（非钙化结节≥4毫米；10项研究）是评估SPR最常用的准则。

The pooled SPR and LCDR were 18.36% (95% confidence interval[CI]: 14.6-22.1) and 0.94% (95% confidence interval: 0.75-1.15), respectively.

综合的敏感性 SPR 和低剂量 CT 检出率 LCDR 分别为 18.36%（95% 置信区间 [CI]: 14.6-22.1）和 0.94%（95% 置信区间: 0.75-1.15）。

Although SPR was significantly higher with NLST criteria than Lung-RADS criteria (25.6% versus 10.4%, p < 0.0001), the LCDR remained similar (0.91% versus 0.95%, p = 0.92).

尽管使用 NLST 标准的 SPR 显著高于 Lung-RADS 标准（25.6% 对比 10.4%，p < 0.0001），但 LCDR 保持相似（0.91% 对比 0.95%，p = 0.92）。

Studies using NLST criteria had a higher SPR in multivariable meta-regression analysis.

使用NLST标准的研究在多变量元回归分析中具有更高的敏感性预测率（SPR）。

Nevertheless, the analysis is limited by significant statistical heterogeneity and publication bias.

然而，该分析受到显著的统计异质性和出版偏倚的限制。

Conclusions

Lung cancer screening by LDCT in HTBC demonstrates comparable SPR and LCDR to regions with lower TB incidencerates.

HTBC地区通过低剂量计算机断层扫描(LDCT)进行的肺癌筛查显示，其敏感性(SPR)和肺癌检出率(LCDR)与结核病发病率较低的地区相当。

Lung-RADS criteria are preferable to NLST criteria for LCS in HTBC to mitigate false-positive rates.

在HTBC地区进行肺癌筛查(LCS)时，使用Lung-RADS标准比使用NLST标准更能降低假阳性率。