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Jun Chen
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P1.11 - Screening and Early Detection (ID 177)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.11-26 - The Epidemiology of Ground Glass Opacity (GGO) Lung Adenocarcinoma: A Network Based Cumulative Meta-Analysis (ID 1324)
09:45 - 18:00 | Author(s): Jun Chen
- Abstract
Background
An increasing number of early-stage NSCLC with ground glass opacity (GGO) have been detected with lung cancer screening. GGO lung cancer is considered as a low-grade adenocarcinoma with noninvasive or minimally invasive growth patterns. The long term survival for GGO lung cancer is very much better compared to the solid counterparts. In this study, we investigate the epidemiological data of GGO lung cancer and outline the variation tendency through cumulative meta-analysis.
Method
Two individual researchers conducted the platform searches on the PubMed, Cochrane Library and Embase from the inception dates to Dec. 1st, 2018. For counting data, such as number of female and non-smoking patients, the single rate is determined along with the corresponding 95% confidence interval (CI). For measurement data, such as average diagnosis age of patients, the single mean value is determined along with the corresponding 95% confidence interval (CI). We performed cumulative meta-analysis and metatrend analysis for the epidemiology data. Data analyses was performed using the Stata version 13.0 (Stata Corp LLC, College Station, Texas, USA).
Result
A meta-analysis from a total of 50 articles with 8565 GGO patients between 1977 and 2018 showed that the rate of female GGO lung cancer was 0.62. The average age of all GGO lung cancer patients was 62.10 and the cumulative meta-analysis showed the average age has been decreasing from 66.40 to 59.06 which variation tendency was statistically significant (p<0.05). From 21 articles included smoking status of 4262 GGO lung cancers, it showed that the total rate for non-smoking patients was 0.72 and there was a significant increasing tendency (0.65 to 0.79, p<0.05).
Conclusion
Our analysis indicates that there are much more GGO lung cancers in females compared to males. In recent years, it showed the average age of GGO lung cancer patients has been declined prominently while the non-smoking rate significantly increased. This investigation has challenged the current criteria of lung cancer screening which excludes a huge population of younger and non-or light-smoking patients who may have GGO lung cancers. Further study has to set up a more refined model which contributes to detect early stage NSCLC with GGO manifestation, which would significantly decrease the mortality of lung cancer.
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P2.11 - Screening and Early Detection (ID 178)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.11-42 - A Prospective Multicenter Study to Assess Combined 6 Tumor Markers for Early Stage Lung Cancer in Patients with Lung Nodule (Now Available) (ID 1583)
10:15 - 18:15 | Author(s): Jun Chen
- Abstract
Background
Lung cancer (LC) is one of the most prevalent and fatal cancer worldwide. The prognosis of LC is closely related to the stage. Low-dose computed tomography (LDCT) is recommended for LC screening in high risk population. More and more lung nodules were detected, but only less than 4% patients were LC. Also, the access to LDCT scan for the high risk population was very low. We conducted a prospective, multicenter study to assess the diagnostic accuracy of combined 6 tumor markers (TMs, CEA, CYFRA21-1, CA15-3, SCC, NSE and ProGRP) for aid in diagnosis in lung nodule patients.
Method
Patients, ≥18years old, who were newly diagnosed with lung nodules, 8‑30 mm, by CT scan were prospectively recruited. Blood samples were obtained by peripheral venipuncture in all patients before the final diagnosis had been established. The patients were divided into two groups according to the pathology result or clinical diagnosis: LC group and benign lung nodule group. The 6 serum TMs were tested for all patients. When these six TMs were assessed in combination, the presence of ≥1 abnormal TM values were considered as abnormal. Sensitivity (SN), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) were calculated and the area under the receiver operating characteristic curve (AUC) was analyzed.
Result
A total 492 predominant lung nodules patients were included in the study analysis, with median age of 59 (IQR: 53-66) years old. 59.6% of the patients were female and 67.5% were non-smokers. Median lung nodule size was 15.75 mm (IQR: 11.75-21.00). 374 (76.02%) patients were diagnosed with LC, of which 94% patients were at I-II stage. SN, SP, PPV, and NPV of the combined 6 markers for LC diagnosis were 39.57% (95%CI, 34.62%, 44.53%), 75.42% (95%CI, 67.66%, 83.19%), 83.62% (95%CI: 78.16%, 89.07%) and 28.25% (95%CI, 23.28%, 33.23%), respectively. AUC showed the combined 6 markers had better diagnostic performance than each individual marker.
Conclusion
Combined 6 TMs increased the diagnostic performance for LC, comparing to the use of individual marker. Given its higher specificity, the presence of ≥1 abnormal TM values could support LC diagnosis in patients with predominant lung nodule detected by CT scan.
