50种癌症的血液检测结果
Results from blood test for 50 cancers

原始链接: https://www.bbc.com/news/articles/c205g21n1zzo

一种由 Grail 开发、目前由英国国民医疗服务体系 (NHS) 试验的新型血液检测,在检测 50 多种癌症方面显示出令人鼓舞的结果,包括那些没有现有筛查计划的癌症,如卵巢癌和胰腺癌。 一项对 25,000 名成年人的北美试验发现,该检测准确地识别了近 1/100 参与者的癌症信号,并在 62% 的阳性病例中确认了诊断——至关重要的是,超过一半的病例是在早期、更易治疗的阶段被检测到的。 Galleri 检测法识别血液中癌细胞 DNA 的片段,并正确地确定了癌症的起源,准确率为 90%。 当与现有筛查相结合时,它使整体癌症检测率提高了七倍。 研究人员称赞该检测法可能“从根本上改变”癌症筛查,但专家强调需要进一步的证据,特别是大规模研究表明癌症死亡率降低。 一项涉及 140,000 名患者的 NHS 大型试验将于明年提供关键数据。

## Galleri 癌症筛查测试:摘要 最近一项Galleri血液检测的试验,旨在检测50种癌症,显示出有希望的结果:在阳性病例中确认了62%的癌症。然而,Hacker News上的讨论强调了解读这些结果的复杂性。 主要担忧围绕**假阳性**以及考虑**基线率**的重要性——癌症在人群中的患病率。即使是高度准确的测试,广泛应用时也可能产生许多误报,导致不必要的焦虑和潜在的有害后续程序。专家强调,该测试的价值取决于癌症类型、阶段和个体风险等因素。 虽然该测试检测到通常缺乏常规筛查的癌症(卵巢癌、胰腺癌等),但其对死亡率的总体影响仍有待观察。成本(899-950美元)和可及性也是因素,一些人指出该测试目前通过订阅和医生要求提供。最终,这场讨论强调了仔细评估收益与风险以及对医学测试中统计概率的细致理解的必要性。
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原文

A blood test for more than 50 types of cancer could help speed up diagnosis, according to a new study.

Results of a trial in North America show that the test was able to identify a wide range of cancers, of which three-quarters don't have any form of screening programme.

More than half the cancers were detected at an early stage, where they are easier to treat and potentially curable.

The Galleri test, made by American pharmaceutical firm Grail, can detect fragments of cancerous DNA that have broken off a tumour and are circulating in the blood. It is currently being trialled by the NHS.

The trial followed 25,000 adults from the US and Canada over a year, with nearly one in 100 getting a positive result. For 62% of these cases, cancer was later confirmed.

Lead researcher Dr Nima Nabavizadeh, associate professor of radiation medicine at Oregon Health & Science University, said the data showed that the test could "fundamentally change" their approach to cancer screening.

He explained that it could help detect many types of cancer "earlier, when the chance of successful treatment or even cure are the greatest".

The test correctly ruled out cancer in over 99% of those who tested negative.

When combined with breast, bowel, lung and cervical screening it increased the number of cancers detected overall seven-fold.

Crucially, three-quarters of cancers detected were those which have no screening programme such as ovarian, liver, stomach, bladder and pancreatic cancer.

The blood test correctly identified the origin of the cancer in nine out of 10 cases.

These impressive results suggest the blood test could eventually have a major role to play in diagnosing cancer earlier.

But scientists not involved in the research say more evidence is needed to show whether the blood test reduces deaths from cancer.

Clare Turnbull, professor of translational cancer genetics at The Institute of Cancer Research, London, said: "Data from randomised studies, with mortality as an endpoint, will be absolutely essential to establish whether seemingly earlier-stage detection by Galleri translates into benefits in mortality."

The topline results are to be released at the European Society for Medical Oncology congress in Berlin on Saturday, but the full details have yet to be published in a peer-reviewed journal.

Much will depend on the results of a three-year trial involving 140,000 NHS patients in England, which will be published next year.

The NHS has previously said that if the results are successful, it would extend the tests to a further one million people.

Sir Harpal Kumar, president of biopharma at Grail called the results "very compelling".

Speaking to BBC Radio 4's Today programme, he said: "The vast majority of people who die from cancer do so because we find their cancers too late."

Many cancers are found when they are "already very advanced" he added, explaining that the aim is to "shift to earlier detection, when we have the chance to use treatments that are much more effective and potentially curative".

But Naser Turabi of Cancer Research UK cautioned that further research is needed to "avoid overdiagnosing cancers that may not have caused harm".

"The UK National Screening Committee will "play a critical role in reviewing the evidence and determining whether these tests should be adopted by the NHS," he added.

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