Combining PET/CT with serum tumor markers to improve the evaluation of histological type of suspicious lung cancers

PLoS One. 2017 Sep 6;12(9):e0184338. doi: 10.1371/journal.pone.0184338. eCollection 2017.

Abstract

Objective: Histological 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 methods: Patients 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.

Results: SCC 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).

Conclusions: SUVmax and serum tumor markers show values in evaluating the histological types of suspicious lung cancers. When properly combined, the diagnostic efficiency can increase significantly.

MeSH terms

  • Adult
  • Aged
  • Area Under Curve
  • Biomarkers, Tumor / blood*
  • Carcinoma, Squamous Cell / blood
  • Carcinoma, Squamous Cell / diagnostic imaging
  • DNA Mutational Analysis
  • ErbB Receptors / blood
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Image Processing, Computer-Assisted
  • Lung Neoplasms / blood*
  • Lung Neoplasms / diagnostic imaging*
  • Male
  • Middle Aged
  • Mutation
  • Positron Emission Tomography Computed Tomography*
  • Regression Analysis
  • Retrospective Studies
  • Small Cell Lung Carcinoma / blood
  • Small Cell Lung Carcinoma / diagnostic imaging

Substances

  • Biomarkers, Tumor
  • Fluorodeoxyglucose F18
  • EGFR protein, human
  • ErbB Receptors

Grants and funding

This work was supported by National Natural Science Foundation of China.