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J. Lou
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P1.03 - Poster Session with Presenters Present (ID 455)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.03-062 - Lung Cancer Screening with Low-Dose CT in China: Study Design and Baseline Results from the First Round Screening Arm (ID 5639)
14:30 - 15:45 | Author(s): J. Lou
- Abstract
Background:
Lung cancer screening with low-dose CT (LDCT) was shown to reduce lung cancer mortality by 20% in the National Lung Screening Trial. However, several other trails have reported that there was no reduction in lung cancer mortality with a LDCT screening strategy. Meanwhile, whether LDCT screens could decrease healthcare costs is yet insufficiently explored. The objectives of the present study was to investigate whether LDCT screening is capable to reduce the lung cancer mortality by at least 20% and analyze the healthcare costs of the lung cancer LDCT screening in China.
Methods:
The present study is a randomized controlled trial of LDCT screening for lung cancer versus usual care. Eligible participants were those aged 45–70 years, and with either of the following risk factors: 1) history of cigarette smoking ≥ 20 pack-years, and, if former smokers, had quit within the previous 15 years; 2) malignant tumors history in immediate family members; 3) personal cancer history; 4) professional exposure to carcinogens; 5) long term exposure to second-hand smoke; 6) long term exposure to cooking oil fumes. All the participants were randomized into a screening arm with three rounds of alternate years LDCT screens and a control arm with three rounds of alternate years questionnaire inquiries. Management of positive screening test was carried out by a prespecified protocol.
Results:
From November 2013 to November 2014, 5933 participants were enrolled in our trail, of which 2933 were assigned to LDCT screening arm, and 3000 to control arm. In the first screening round, 2892 participants (98.6%) undergo LDCT after randomization. At baseline 742 subjects (25.7%) showed noncalcified nodules (NCN) larger than 4 mm. 69 cases were highly suspected of lung cancer according to the suggestion of three experienced experts. The highly suspected cases were accounting for 9.30% of all NCN subjects and 2.39% of all the screening arm participants. By March 2016, 26 cases underwent surgical resections, including 23 lung adenocarcinoma, 1 lung squamous cell carcinoma and 2 benign lesions, representing a positive lung cancer detection rate with low-dose CT screening of 0.83%(24/2892). Among all the lung cancer cases, 23/24 (95.8%) had stage I disease, and 1/24 (4.2%) had stage II disease. The second round screening was still ongoing since May 2016.
Conclusion:
Screening with LDCT increases the detection rate of early stage lung cancers (stage I and II) in a high risk population.
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P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.05-009 - Clinical Value of Circulating Tumor Cell in the Differential Diagnosis of Solitary Pulmonary Nodule (ID 4977)
14:30 - 15:45 | Author(s): J. Lou
- Abstract
Background:
The diagnosis of lung cancer suffers from the lack of accurate, noninvasive and early diagnostic tests. Low-dose helical computed tomography (LDCT) identifies millions of solitary pulmonary nodules (SPN) annually, many of which are undiagnosed as either malignant or benign. When removed surgically, 18%-25% of the nodules are benign, which leads to unnecessary treatment procedures for surgeons, stress and panic for patients and waste of medical resources for government. Therefore, an accurate noninvasive test that can discriminate benign SPN from malignant is urgently needed. Circulating tumor cells (CTCs) are cells shed from either primary or secondary tumors that migrate into the circulatory system and exist at the early stage of cancer. In recent years, CTC has become the research hotspot because of its great significance in the early diagnosis of cancer, disease monitoring, prognosis evaluation and guiding individualized treatment. In this study, we evaluated the application value of CTC in the differential diagnosis of SPN.
Methods:
Peripheral blood samples were collected from 134 patients with solitary pulmonary nodule in Shanghai Chest Hospital from September 2013 to January 2015, including 80 patients with malignant nodule and 54 with benign nodule. CTC levels of the above subjects were detected by LT-PCR (ligand-targeted polymerase chain reaction, LT-PCR) assay, and serum CEA and CYFRA21-1 were detected by flow fluorescence assay.
Results:
The CTC levels of malignant SPN patients were significantly higher than that of benign SPN patients (P<0.001). The area under the Receiver Operating Characteristic (ROC) curves of CTC and CEA were 0.817(95% CI: 0.743~0.891) and 0.613(95% CI: 0.508~0.718) respectively, while the CYFRA21-1 had no significant meaning in the differential diagnosis of SPN. The positive and negative predictive value (PPV and NPV) in differential diagnosis of SPN for CTC were 89% and 74%. Then the patients were divided into three groups according to the nodule diameter to evaluate the diagnostic value of CTC in SPN with different size. For SPN with diameter less than 8 mm, the PPV and NPV of CTC were 86% and 57%; For SPN with diameter between 8 mm and 20 mm, the PPV and NPV of CTC were 88% and 81%; For SPN with diameter greater than 20 mm, the PPV and NPV of CTC were 92% and 68%.
Conclusion:
Compared with traditional tumor marker, CTC detection could provide more clinical value in differential diagnosis of solitary pulmonary nodule.
