Assessment of Relationship Between CT Features and Serum Tumor Marker Index in Early-stage Lung Adenocarcinoma

Abstract

The study aimed to assess the relationship between tumor marker index (TMI) and high-resolution computed tomography features in early-stage lung adenocarcinoma. Seventy-four stage IA lung adenocarcinomas confirmed pathologically were retrospectively evaluated. Lung nodules were divided into two types: solid nodule (SN) and subsolid nodule (SSN). The maximum diameters on mediastinal window in axial imaging (Dm) and tumor shadow disappearance rate (TDR) were measured. Meanwhile, other computed tomography features of lung nodules were also recorded. TMI represents the geometric mean of normalized CEA and CYFRA 21-1 values, and the discriminatory value of TMI in this study was set at 1.0. The evaluation of discriminatory values for Dm and the TMI between SNs and SSNs was done with Mann-Whitney U-test. The relationship between TDR and TMI in SSNs was evaluated by Pearson correlation analysis. Of 74 cases, 40 cases (54.05%) showed SNs and 34 cases (45.95%) showed SSNs. Dm and TMI were higher in SNs than in SSNs (z = -4.782, P < 0.001; z = -2.647, P = 0.008). TDR demonstrated negative relationship with TMI in SSNs (r = -0.448, P = 0.008). Spiculation (odds ratio [OR] = 14.685; 95% confidence interval [CI]: 2.739-78.729; P = 0.002), nodule type (OR = 6.215; 95% CI: 1.531-25.228; P = 0.011), and gender (OR = 0.227; 95% CI: 0.062-0.833; P = 0.025) were independent factors associated with TMI. Early-stage lung adenocarcinoma with lower TDR coexisting with spiculation was associated with higher TMI, especially in patients with solid nodule, which tended to have poor prognosis.