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Hongxiang Feng



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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): Hongxiang Feng

      • Abstract
      • Slides

      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.

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