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

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2.	胡钰, 方进, 邓达标, 等. 低剂量胸部 CT 对肺癌筛查的研究进展. 中国医学影像技术, 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.
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5.	张晓辉, 陈成, 曾辉, 等. 孤立性肺结节恶性概率估算临床预测模型的建立. 实用癌症杂志, 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.	李艳平, 王群, 赵姿红, 等. 联合检测肿瘤标志物在肺癌诊断中的临床价值. 中华核医学与分子影像杂志, 2013, 33(5): 336-339.
9.	薛珊, 查琼芳, 赵旭霁, 等. CEA、CA125、CYFRA21-1、NSE 和 SCC 对非小细胞肺癌化疗效果及进展评估的价值. 山东医药, 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.	倪莲芳, 刘新民. 血清肿瘤标记物对孤立性肺结节良恶性的诊断价值. 北京大学学报(医学版), 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.	欧兆荣, 陶连琴, 时国朝, 等. 孤立性肺结节的影像学特征及两种肺癌预测模型的比较. 中国呼吸与危重监护杂志, 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. 胡钰, 方进, 邓达标, 等. 低剂量胸部 CT 对肺癌筛查的研究进展. 中国医学影像技术, 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. 中华医学会呼吸病学分会肺癌学组, 中国肺癌防治联盟专家组. 肺部结节诊治中国专家共识. 中华结核和呼吸杂志, 2015, 38(4): 249-254.
5. 张晓辉, 陈成, 曾辉, 等. 孤立性肺结节恶性概率估算临床预测模型的建立. 实用癌症杂志, 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. 李艳平, 王群, 赵姿红, 等. 联合检测肿瘤标志物在肺癌诊断中的临床价值. 中华核医学与分子影像杂志, 2013, 33(5): 336-339.
9. 薛珊, 查琼芳, 赵旭霁, 等. CEA、CA125、CYFRA21-1、NSE 和 SCC 对非小细胞肺癌化疗效果及进展评估的价值. 山东医药, 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. 倪莲芳, 刘新民. 血清肿瘤标记物对孤立性肺结节良恶性的诊断价值. 北京大学学报(医学版), 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. 欧兆荣, 陶连琴, 时国朝, 等. 孤立性肺结节的影像学特征及两种肺癌预测模型的比较. 中国呼吸与危重监护杂志, 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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