Abstract A22: Spirometric surveillance for premalignant and malignant bronchial lesions
Bibliographic record
Abstract
Abstract Background: Chronic obstructive pulmonary disease (COPD) and lung cancer (LC) are diseases that share common risk factors. It has been reported that more than half of the patients diagnosed with LC also suffer from COPD. Although COPD is a well known risk factor for LC, the relationship between impaired lung function (LF) and the incidence and progression of pre-malignant lesions (PMLs) in the central airways is still unclear. Methods: The study included 217 high-risk patients from a hospital-based lung cancer surveillance cohort who underwent bronchoscopy with endobronchial biopsy of suspicious lesions, at the Roswell Park Cancer Institute, Buffalo, New York. All patients had lung function measurement within 6 months preceding their baseline biopsy. Baseline histopathology diagnoses included 91squamous metaplasia (SM), 25 squamous dysplasia (SD), 1 in-situ carcinoma and 5 invasive bronchial carcinoma. Follow-up bronchoscopy and biopsy were performed on 69 patients. Sixteen patients had a progression of the baseline lesion to a higher grade. The relationship between the baseline LF measures and the incidence and progression of PMLs were examined using regression models. Results: Patients with forced expiratory volume in 1 second percent predicted (FEV1%) of <50% had 4.5 times greater risk of being diagnosed with PML/cancer, when compared to patients with FEV1% ≥80. Increased risk was noted for all grades of PMLs and cancers, with the risk being almost 8 times for squamous dysplasia [Odds ratio = 7.95; 95%confidence interval (CI) =1.77–35.6]. Similarly, FEV-1/FVC ratio of <50% was associated with 3 times greater risk of detecting a PML/cancer. When COPD was classified based on GOLD criteria, the patients with severe COPD had 2.7 times and 4.8 times greater risk of being detected with SM and SD, respectively. The risk persisted for SD even when an age standardized classification was used to define COPD. COPD patients also had a non-statistically significant 2.5 times greater risk of their baseline lesion progressing to a higher grade [Hazard Ratio 2.48 (95% CI 0.65 – 9.41), p-value - 0.18)]. The mean time to progression from a lower grade lesion to a higher grade was 27 months for patients with COPD and 50 months for patients without COPD. Conclusion: Impaired LF can be a good predictor of occurrence and progression of PMLs in central airways of high risk patients. Spirometric measurement of lung function can be used as an additional tool for identifying target populations in need of more aggressive LC surveillance. Citation Information: Cancer Prev Res 2010;3(1 Suppl):A22.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".