Diagnostic value of tumor marker combining the probability of malignancy model in pulmonary nodules_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

JIA Guohua , ZHOU Shuimei ,  WANG Jing

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R.China;

Corresponding?author：

WANG Jing, Email: wangjing@zzu.edu.cn

Keywords：

Tumor marker; The probability of malignancy model; Pulmonary nodules; Lung cancer; Dignosis

DOI：

10.7507/1671-6205.201610054

Video：

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Objective To investigate the diagnostic value of tumor marker combining the probability of malignancy model in pulmonary nodules. Methods A total of 117 patients with pulmonary nodules diagnosed between January 2013 and January 2016 were retrospectively analyzed. Seventy-six cases of the patients diagnosed with cancer were selected as a lung cancer group. Forty-one cases of the patients diagnosed with benign lesions were selected as a benign group. Tumor markers were detected and the probability of malignancy were calculated. Results The positive rate of carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), neuron-specific enolase (NSE), cytokeratin marker (CYFRA21-1), and the probability of malignancy in the lung caner group were significantly higher than those of the benign group. The sensitivity, specificity, and accuracy of CEA, CA125, NSE, CYFRA21-1 combined detection were 72.37%, 73.17%, and 72.65%, respectively. Using the probability of malignancy model to calculate each pulmonary nodules, the area under ROC curve was 0.743 which was higher than 0.7; and 28.5% was selected as cut-off value based on clinical practice and ROC curve. The sensitivity, specificity, and accuracy of the probability of malignancy model were 63.16%, 78.05%, and 68.68%, respectively. The sensitivity, specificity, and accuracy of tumor marker combining the probability of malignancy model were 93.42%, 68.29%, and 92.31%, respectively. The sensitivity and accuracy of tumor marker combining the probability of malignancy model were significantly improved compared with tumor markers or the probability of malignancy model single detection (P<0.01). Conclusion The tumor marker combining the probability of malignancy model can improve the sensitivity and accuracy in diagnosis of pulmonary nodules.

Citation： JIA Guohua, ZHOU Shuimei, WANG Jing. Diagnostic value of tumor marker combining the probability of malignancy model in pulmonary nodules. Chinese Journal of Respiratory and Critical Care Medicine, 2017, 16(4): 337-340. doi: 10.7507/1671-6205.201610054 Copy

1.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin, 2015, 65(1): 5-29.
2.	胡鈺, 方進, 鄧達標, 等. 低劑量胸部 CT 對肺癌篩查的研究進展. 中國醫學影像技術, 2015, 31(1): 146-149.
3.	Rampinelli C, Calloni SF, Minotti M, et al. Spectrum of early lung cancer presentation in low-dose screening CT: a pictorial review. Insights Imaging, 2016, 7(3): 449-459.
4.	中華醫學會呼吸病學分會肺癌學組, 中國肺癌防治聯盟專家組. 肺部結節診治中國專家共識. 中華結核和呼吸雜志, 2015, 38(4): 249-254.
5.	張曉輝, 陳成, 曾輝, 等. 孤立性肺結節惡性概率估算臨床預測模型的建立. 實用癌癥雜志, 2016, 31(1): 59-62.
6.	Gould MK, Donington J, Lynch WR, et al. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e93S-e120S.
7.	Rezaeetalab F, Aryana K, Attaran D, et al. The role of octreotate scan in discrimination of solitary pulmonary nodule. World J Nucl Med, 2014, 13(1): 46-49.
8.	李艷平, 王群, 趙姿紅, 等. 聯合檢測腫瘤標志物在肺癌診斷中的臨床價值. 中華核醫學與分子影像雜志, 2013, 33(5): 336-339.
9.	薛珊, 查瓊芳, 趙旭霽, 等. CEA、CA125、CYFRA21-1、NSE 和 SCC 對非小細胞肺癌化療效果及進展評估的價值. 山東醫藥, 2015, 55(25): 8-11.
10.	Bekci TT, Senol T, Maden E. The efficacy of serum carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 (CA15-3), α-fetoprotein (AFP) and human chorionic gonadotropin (hCG) levels in determining the malignancy of solitary pulmonary nodules. J Int Med Res, 2009, 37(2): 438-445.
11.	Wang H, Zhang X, Liu X, et al. Diagnostic value of bronchoalveolar lavage fluid and serum tumor markers for lung cancer. J Cancer Res Ther, 2016, 12(1): 355-358.
12.	Pang L, Wang J, Jiang Y, et al. Decreased levels of serum cytokeratin 19 fragment CYFRA 21-1 predict objective response to chemotherapy inpatients with non-small cell lung cancer. Exp Ther Med, 2013, 6(2): 355-360.
13.	Chen F, Wang XY, Han XH, et al. Diagnostic value of Cyfra21-1, SCC and CEA for differentiation of early-stage NSCLC from benign lung disease. Int J Clin Exp Med, 2015, 8(7): 11295-11300.
14.	Seemann MD, Beinert T, Fürst H, et al. An evaluation of the tumour markers, carcinoembryonic antigen (CEA), cytokeratin marker (CYFRA 21-1) and neuron-specific enolase (NSE) in the differentiation of malignant from benign solitary pulmonary lesions. Lung Cancer, 1999, 26(3): 149-155.
15.	Patz EF Jr, Campa MJ, Gottlin EB, et al. Biomarkers to help guide management of patients with pulmonary nodules. Am J Respir Crit Care Med, 2013, 188(4): 461-465.
16.	Wang R, Wang GQ, Zhang N, et al. Clinical evaluation and cost-effectiveness analysis of serum tumor markers in lung cancer. Biomed Res Int, 2013: 195692.
17.	倪蓮芳, 劉新民. 血清腫瘤標記物對孤立性肺結節良惡性的診斷價值. 北京大學學報(醫學版), 2014, 46(5): 707-710.
18.	Gould MK, Ananth L, Barnett PG, et al. A clinical model to estimate the pretest probability of lung cancer in pmients with solitary pulmonary nodules. Chest, 2007, 131(2): 383-388.
19.	歐兆榮, 陶連琴, 時國朝, 等. 孤立性肺結節的影像學特征及兩種肺癌預測模型的比較. 中國呼吸與危重監護雜志, 2012, 11(2): 168-171.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin, 2015, 65(1): 5-29.
2. 胡鈺, 方進, 鄧達標, 等. 低劑量胸部 CT 對肺癌篩查的研究進展. 中國醫學影像技術, 2015, 31(1): 146-149.
3. Rampinelli C, Calloni SF, Minotti M, et al. Spectrum of early lung cancer presentation in low-dose screening CT: a pictorial review. Insights Imaging, 2016, 7(3): 449-459.
4. 中華醫學會呼吸病學分會肺癌學組, 中國肺癌防治聯盟專家組. 肺部結節診治中國專家共識. 中華結核和呼吸雜志, 2015, 38(4): 249-254.
5. 張曉輝, 陳成, 曾輝, 等. 孤立性肺結節惡性概率估算臨床預測模型的建立. 實用癌癥雜志, 2016, 31(1): 59-62.
6. Gould MK, Donington J, Lynch WR, et al. Evaluation of individuals with pulmonary nodules: when is it lung cancer? Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e93S-e120S.
7. Rezaeetalab F, Aryana K, Attaran D, et al. The role of octreotate scan in discrimination of solitary pulmonary nodule. World J Nucl Med, 2014, 13(1): 46-49.
8. 李艷平, 王群, 趙姿紅, 等. 聯合檢測腫瘤標志物在肺癌診斷中的臨床價值. 中華核醫學與分子影像雜志, 2013, 33(5): 336-339.
9. 薛珊, 查瓊芳, 趙旭霽, 等. CEA、CA125、CYFRA21-1、NSE 和 SCC 對非小細胞肺癌化療效果及進展評估的價值. 山東醫藥, 2015, 55(25): 8-11.
10. Bekci TT, Senol T, Maden E. The efficacy of serum carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 15-3 (CA15-3), α-fetoprotein (AFP) and human chorionic gonadotropin (hCG) levels in determining the malignancy of solitary pulmonary nodules. J Int Med Res, 2009, 37(2): 438-445.
11. Wang H, Zhang X, Liu X, et al. Diagnostic value of bronchoalveolar lavage fluid and serum tumor markers for lung cancer. J Cancer Res Ther, 2016, 12(1): 355-358.
12. Pang L, Wang J, Jiang Y, et al. Decreased levels of serum cytokeratin 19 fragment CYFRA 21-1 predict objective response to chemotherapy inpatients with non-small cell lung cancer. Exp Ther Med, 2013, 6(2): 355-360.
13. Chen F, Wang XY, Han XH, et al. Diagnostic value of Cyfra21-1, SCC and CEA for differentiation of early-stage NSCLC from benign lung disease. Int J Clin Exp Med, 2015, 8(7): 11295-11300.
14. Seemann MD, Beinert T, Fürst H, et al. An evaluation of the tumour markers, carcinoembryonic antigen (CEA), cytokeratin marker (CYFRA 21-1) and neuron-specific enolase (NSE) in the differentiation of malignant from benign solitary pulmonary lesions. Lung Cancer, 1999, 26(3): 149-155.
15. Patz EF Jr, Campa MJ, Gottlin EB, et al. Biomarkers to help guide management of patients with pulmonary nodules. Am J Respir Crit Care Med, 2013, 188(4): 461-465.
16. Wang R, Wang GQ, Zhang N, et al. Clinical evaluation and cost-effectiveness analysis of serum tumor markers in lung cancer. Biomed Res Int, 2013: 195692.
17. 倪蓮芳, 劉新民. 血清腫瘤標記物對孤立性肺結節良惡性的診斷價值. 北京大學學報(醫學版), 2014, 46(5): 707-710.
18. Gould MK, Ananth L, Barnett PG, et al. A clinical model to estimate the pretest probability of lung cancer in pmients with solitary pulmonary nodules. Chest, 2007, 131(2): 383-388.
19. 歐兆榮, 陶連琴, 時國朝, 等. 孤立性肺結節的影像學特征及兩種肺癌預測模型的比較. 中國呼吸與危重監護雜志, 2012, 11(2): 168-171.

Chinese Journal of Respiratory and Critical Care Medicine

Diagnostic value of tumor marker combining the probability of malignancy model in pulmonary nodules

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