Abstract
ObjectiveHistological type is important for determining the management of patients with suspicious lung cancers. In this study, PET/CT combined with serum tumor markers were used to evaluate the histological type of lung lesions.Materials and methodsPatients with suspicious lung cancers underwent 18F-FDG PET/CT and serum tumor markers detection. SUVmax of the tumor and serum levels of tumor markers were acquired. Differences in SUVmax and serum levels of tumor markers among different histological types of lung cancers and between EGFR mutation statues of adenocarcinoma were compared. The diagnostic efficiencies of SUVmax alone, each serum tumor marker alone, combined tumor markers and the combination of both methods were further assessed and compared.ResultsSCC had the highest level of SUVmax, followed by SCLC and adenocarcinoma, and benign lesions had a lowest level. CYFRA21-1 and SCC-Ag were significantly higher in SCC, NSE was significantly higher in SCLC (P<0.001), and CEA was higher in adenocarcinoma (P = 0.343). The diagnostic efficiencies in evaluating histological types of suspicious lung cancers were insufficient when using each serum tumor marker or SUVmax alone. When combined, the AUC, sensitivity and specificity increased significantly (P<0.05 for all). Additionally, to adenocarcinoma, no significant difference was found between EGFR mutation statuses in SUVmax or serum tumor markers (P>0.05 for all).ConclusionsSUVmax and serum tumor markers show values in evaluating the histological types of suspicious lung cancers. When properly combined, the diagnostic efficiency can increase significantly.
Highlights
Lung cancer, a malignant lung tumor, is the main cause of cancer-related deaths worldwide, with most patients present with advanced disease and poor long-term prognosis [1]
squamous-cell carcinoma (SCC) had the highest level of SUVmax, followed by small-cell lung carcinoma (SCLC) and adenocarcinoma, and benign lesions had a lowest level
CYFRA21-1 and squmaous cell carcinoma antigen (SCC-Ag) were significantly higher in SCC, neuron specific enolase (NSE) was significantly higher in SCLC (P
Summary
A malignant lung tumor, is the main cause of cancer-related deaths worldwide, with most patients present with advanced disease and poor long-term prognosis [1]. Targeted therapy of lung cancer is growing in importance for advanced lung cancer [4, 5]. Three broad classes of lung lesions are distinguished: benign lesions, non-small-cell lung carcinoma (NSCLC) and small-cell lung carcinoma (SCLC). The three main subtypes of NSCLC are adenocarcinoma, squamous-cell carcinoma (SCC) and large-cell carcinoma [3, 4]. To patients with adenocarcinoma, the mutation status of the epidermal growth factor receptor (EGFR) plays an important role in guiding the EGFR-based targeted therapy [1, 6,7,8]
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