低剂量计算机断层扫描（LDCT）筛查是一种更有效的方法，有潜力更准确地检测肺癌。我们旨在进行一项荟萃分析，以评估以基线LDCT筛查肺癌为主要评估对象的人群筛查研究的准确性。我们搜索了MEDLINE，Excerpta Medica Database和Web of Science上至2022年4月10日发布的文章。根据包含和排除标准，提取了筛查检测的真阳性、假阳性、假阴性和真阴性数据。使用诊断准确性研究评估-2（QUADAS-2）评估文献的质量。使用双变量随机效应模型估算汇总灵敏度和特异度。使用分层总结接收者操作特征分析法计算曲线下面积（AUC）。使用Higgins I²统计量测量研究间的异质性，并使用Deeks漏斗图和线性回归检验评估出版物偏倚。共鉴定了49个研究，涉及157,762个个体，主要来自欧洲和美洲（38个研究），其中10个来自亚洲，1个来自大洋洲。招募期为1992年至2018年，大多数受试者为40至75岁。分析显示，LDCT肺癌筛查的AUC为0.98（95% CI：0.96-0.99），总体敏感度和特异度分别为0.97（95% CI：0.94-0.98）和0.87（95% CI：0.82-0.91）。漏斗图和检验结果显示，包括的研究中不存在明显的出版物偏倚。基线LDCT作为肺癌筛查技术具有较高的敏感性和特异性。然而，需要对整个研究人群（包括基线筛查结果为阴性的人）进行长期随访，以提高LDCT筛查的准确性。版权所有©2023年中国医学会，由沃尔特斯·克鲁尔公司根据CC-BY-NC-ND许可证制作。

Screening using low-dose computed tomography (LDCT) is a more effective approach and has the potential to detect lung cancer more accurately. We aimed to conduct a meta-analysis to estimate the accuracy of population-based screening studies primarily assessing baseline LDCT screening for lung cancer.MEDLINE, Excerpta Medica Database, and Web of Science were searched for articles published up to April 10, 2022. According to the inclusion and exclusion criteria, the data of true positives, false-positives, false negatives, and true negatives in the screening test were extracted. Quality Assessment of Diagnostic Accuracy Studies-2 was used to evaluate the quality of the literature. A bivariate random effects model was used to estimate pooled sensitivity and specificity. The area under the curve (AUC) was calculated by using hierarchical summary receiver-operating characteristics analysis. Heterogeneity between studies was measured using the Higgins I2 statistic, and publication bias was evaluated using a Deeks' funnel plot and linear regression test.A total of 49 studies with 157,762 individuals were identified for the final qualitative synthesis; most of them were from Europe and America (38 studies), ten were from Asia, and one was from Oceania. The recruitment period was 1992 to 2018, and most of the subjects were 40 to 75 years old. The analysis showed that the AUC of lung cancer screening by LDCT was 0.98 (95% CI: 0.96-0.99), and the overall sensitivity and specificity were 0.97 (95% CI: 0.94-0.98) and 0.87 (95% CI: 0.82-0.91), respectively. The funnel plot and test results showed that there was no significant publication bias among the included studies.Baseline LDCT has high sensitivity and specificity as a screening technique for lung cancer. However, long-term follow-up of the whole study population (including those with a negative baseline screening result) should be performed to enhance the accuracy of LDCT screening.Copyright © 2023 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.