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    Home > Active Ingredient News > Antitumor Therapy > PLOS MED: Can cancer investigation be conducted through a simple blood test?

    PLOS MED: Can cancer investigation be conducted through a simple blood test?

    • Last Update: 2021-09-11
    • Source: Internet
    • Author: User
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    Unexpected weight loss (UWL) is a manifestation of cancer, and there is currently no consensus on the most appropriate investigative strategy in primary care
    .
    UWL patients recorded by primary care physicians are more likely to be diagnosed with the following cancers within 3 months : pancreatic cancer , cancer of unknown primary, gastroesophageal cancer, lymphoma , liver and gallbladder, lung, intestine, and kidney
    .

    Consensus UWL patients recorded by primary care physicians are more likely to be diagnosed with the following cancers within 3 months : pancreatic cancer , unknown primary cancer, gastroesophageal cancer, lymphoma , liver and gallbladder, lung, intestine, and kidney
    .
    UWL patients recorded by primary care physicians are more likely to be diagnosed with the following cancers within 3 months : pancreatic cancer , cancer of unknown primary, gastroesophageal cancer, lymphoma , liver and gallbladder, lung, intestine, and kidney
    .
    Diagnosing pancreatic cancer and lymphoma

    This association is greatest when men are over 60 years old and women are over 80 years old
    .
    The current survey guidelines are mainly based on a simple combination of clinical characteristics (individual risk factors, signs, symptoms, and abnormal blood tests) to select patients for single-site cancer investigation

    .

    Since most UWL patients who go to primary medical institutions do not suffer from cancer, it is necessary to adopt diagnostic strategies for patients with a lower risk of cancer to avoid unnecessary invasive and expensive investigations
    .
    Previous work has shown that individual common clinical features will increase the possibility of cancer, which is enough to rule out cancer screening
    .

    Previous work has shown that individual common clinical features will increase the possibility of cancer, which is enough to rule out cancer screening
    .
    Previous work has shown that individual common clinical features will increase the possibility of cancer, which is enough to rule out cancer screening
    .

    However, the absence of individual common clinical features, including pairs of normal inflammatory markers, does not sufficiently reduce the possibility of cancer, thereby precluding patients from undergoing further cancer screening
    .
    When a patient develops UWL, the primary care physician usually requires multiple blood tests

    .
    There is currently no guidance on how clinicians should interpret these blood tests comprehensively, or which tests are most relevant to clinical practice

    .
    When the baseline examination is normal, the observational waiting method may be preferable to the invasive examination

    .

    In order to determine which clinical features can be used together to stratify UWL patients according to cancer risk, more complex combinations may change cancer risk, thereby fully eliminating the need for investigation
    .
    Experts from the Primary Care Centre of Oxford University in the United Kingdom conducted a study and the results were published in the journal PLOS Medicine

    .

    The researchers used data from 63,973 adults (average age 59, standard deviation 21 years; 42% male) to predict a large representative primary care electronic health record in the UK from January 1, 2000 to December 31, 2012 Cancers in UWL patients recorded in
    .
    Using logistic regression and reverse stepwise selection of covariates, three clinical prediction models were obtained

    .
    Sm, only symptom model; STm, symptom and test model; Tm, only test model

    .
    A simple clinical risk score is proposed for the model with the greatest clinical utility in decision curve analysis

    .

    The decision curve analysis compares the three models in terms of net benefits (Figure 2a) and avoidance surveys (Figure 2b)
    .

    The results showed that compared with Sm, STm and Tm showed better resolution (AUC≥0.
    91), calibration and greater clinical utility

    .
    Among them, Tm is the simplest, including age group, gender, albumin, alkaline phosphatase, liver enzymes, C-reactive protein, hemoglobin, platelets and total number of white blood cells
    .

    The results showed that compared with Sm, STm and Tm showed better resolution (AUC≥0.
    91), calibration and greater clinical utility

    .
    The results showed that compared with Sm, STm and Tm showed better resolution (AUC≥0.
    91), calibration and greater clinical utility

    .

    A Tm score of 5 points can balance the exclusion (sensitivity 84.
    0%, positive likelihood ratio 5.
    36) and exclusion (specificity 84.
    3%, negative likelihood ratio 0.
    19) for further cancer inspections

    .
    If the Tm score is 1, it will be excluded first (sensitivity 97.
    5%)

    .
    Under this threshold, 35 out of every cancer patient referred for UWL in primary care, and out of every unreferred cancer patient, 1730 are exempt from referral

    .

    A Tm score of 5 points can balance the exclusion (sensitivity 84.
    0%, positive likelihood ratio 5.
    36) and exclusion (specificity 84.
    3%, negative likelihood ratio 0.
    19) for further cancer inspections

    .
    A Tm score of 5 points can balance the exclusion (sensitivity 84.
    0%, positive likelihood ratio 5.
    36) and exclusion (specificity 84.
    3%, negative likelihood ratio 0.
    19) for further cancer inspections

    .

    The decision curve analysis compares the three models in terms of net benefits (Figure 2a) and avoidance surveys (Figure 2b)
    .

    In summary, the results of the study show that a simple combination of abnormal blood tests can be used to identify UWL patients who need to be referred for investigation, while people with a combination of normal results can be exempt from referral
    .

    In summary, the results of the study show that a simple combination of abnormal blood tests can be used to identify UWL patients who need to be referred for investigation, while people with a combination of normal results can be exempt from referral
    .
    In summary, the results of the study show that a simple combination of abnormal blood tests can be used to identify UWL patients who need to be referred for investigation, while people with a combination of normal results can be exempt from referral
    .

     

    references:

    Combining simple blood tests to identify primary care patients with unexpected weight loss for cancer investigation: Clinical risk score development, internal validation, and net benefit analysis.
    https://doi.
    org/10.
    1371/journal.
    pmed.
    1003728

    Combining simple blood tests to identify primary care patients with unexpected weight loss for cancer investigation: Clinical risk score development, internal validation, and net benefit analysis.


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