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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
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
P2.11-15 - Detection of Circulating Genetically Abnormal Cells Improves the Diagnostic Accuracy in Lung Cancer Presenting with GGNs (ID 1533)
10:15 - 18:15 | Author(s): Chuoji Huang
Popularization of low-dose computed tomography (LDCT) screening enables more finding of pulmonary ground glass nodules (GGNs). It remains a challenge for distinguishing between malignant and benign nodules in patients with size ≤30mm GGNs depending on CT. Moreover, serum tumor markers showed poor prediction value. There is an urgent need to develop a noninvasive and highly accurate biomarker for detection. Recent studies have suggested that circulating genetically abnormal cells (CACs) can be identified by fluorescence in situ hybridization (FISH) from peripheral blood of early-stage lung cancer in Caucasian. This study aimed to use CACs to improve the diagnostic accuracy of early-stage lung cancer with GGNs in Chinese population.Method
Peripheral blood was collected from 107 patients with GGNs and 55 healthy donors. All GGNs identified by CT were between 5-30mm in diameter and confirmed with histopathological diagnosis after surgical resection. The level of serum-based biomarkers (CEA, NSE, TPSA, SCC, PROGRP, CA19-9 and CYFRA21-1) were measured. CACs were enriched by density gradient separation, and visualized by 3p22.1, 3q29, 10q22.3, CEP10 FISH. CACs were identified by finding gains in two or more probes.Result
Of these 107 GGNs, 96 were malignant (45 pure GGNs and 51 mixed GGNs) and 11 were Benign. All malignant GGNs were stage I lung adenocarcinomas. CACs were detected in 68 of 96 lung cancers, while serum-based biomarkers were just positive in 39 of those. The sensitivity, specificity of CACs test were 70.8%, 77.3% respectively for this cohort (96 malignant GGNs, 11 benign GGNs and 55 healthy donors). The area under the receiver operating characteristic (ROC) curve was 0.760 from this data set. There was no significant difference in CACs test sensitivity between GGNs size of <20mm and ≥20mm (71.3% vs 68.8%, p=0.84). Comparing to serum-based biomarkers, the sensitivity of CACs test was significantly improved. Combining the CACs test results with serum-based biomarkers, the overall sensitivity increased to 77.1% without lowering specificity.
Sensitivity on malignant GGNs (N=96) Sensitivity on malignant pure GGNs (N=45) Sensitivity on malignant mixed GGNs (N=51) CACs 70.8% 68.9% 72.5% serum-based biomarkers 40.6% 40.0% 41.2% Sig. P<0.05 P<0.05 P<0.05
Our study showed that using CACs as a noninvasive malignant biomarker could improve the diagnostic accuracy in early-stage lung cancer presenting with GGNs.
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