scholarly journals The Value of A Seven-Autoantibody Panel Combined With The Mayo Model In The Differential Diagnosis of Pulmonary Nodules 

2020 ◽  
Author(s):  
Zhougui Ling ◽  
Jifei Chen ◽  
Zhongwei Wen ◽  
Xiaomou Wei ◽  
Rui Su ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Early Detection ◽  
Sensitivity And Specificity ◽  
Detection Rate ◽  
Early Stage ◽  
Pulmonary Nodules ◽  
Enzyme Linked Immunosorbent Assay ◽  
Clinical Value ◽  
Chi Square ◽  
Early Stage Lung Cancer

Abstract BACKGROUND: Identifying malignant pulmonary nodules and detecting early-stage lung cancer (LC) could reduce mortality. This study investigated the clinical value of a seven-autoantibody (7-AAB) panel in combination with the Mayo model for the early detection of LC and distinguishing benign from malignant pulmonary nodules (MPNs).METHODS: The concentrations of the elements of a 7-AAB panel were quantitated by enzyme-linked immunosorbent assay (ELISA) in 806 participants. The probability of MPNs was calculated using the Mayo predictive model. The 7-AAB panel and the Mayo model performances were analyzed by receiver operating characteristic (ROC) analyses, and the difference between groups was evaluated by Chi-square tests (χ2).RESULTS: The combined area under the ROC curve (AUC) for all 7 AABs was higher than that of a single one. The 7-AAB panel sensitivities were 67.5% in the stage I-II LC patients and 60.3% in stage III-IV patients, with a specificity of 89.6% for the healthy controls and 83.1% for benign lung disease patients. The detection rate of the 7-AAB panel in the early-stage LC patients was higher than that of traditional tumor markers. The AUC of the 7-AAB panel combined with the Mayo model was higher than that of the 7-AAB panel alone or the Mayo model alone in distinguishing MPN from benign nodules. For early-stage MPN, the sensitivity and specificity of the combination were 93.5% and 58.0%, respectively. For advanced-stage MPN, the sensitivity and specificity of the combination were 91.4% and 72.8%, respectively. The combination of the 7-AAB panel with the Mayo model significantly improved the detection rate of MPN, but the positive predictive value (PPV) and the specificity were not improved when compared with either the 7-AAB panel alone or the Mayo model alone.CONCLUSION: Our study confirmed the clinical value of the 7-AAB panel for the early detection of lung cancer, and in combination with the Mayo model, could be used to distinguish benign from malignant pulmonary nodules.

scholarly journals The Value of a Seven-Autoantibody Panel Combined with the Mayo Model in the Differential Diagnosis of Pulmonary Nodules

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Zhougui Ling ◽  
Jifei Chen ◽  
Zhongwei Wen ◽  
Xiaomou Wei ◽  
Rui Su ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Early Detection ◽  
Sensitivity And Specificity ◽  
Detection Rate ◽  
Early Stage ◽  
Pulmonary Nodules ◽  
Enzyme Linked Immunosorbent Assay ◽  
Clinical Value ◽  
Chi Square ◽  
Early Stage Lung Cancer

Background. Identifying malignant pulmonary nodules and detecting early-stage lung cancer (LC) could reduce mortality. This study investigated the clinical value of a seven-autoantibody (7-AAB) panel in combination with the Mayo model for the early detection of LC and distinguishing benign from malignant pulmonary nodules (MPNs). Methods. The concentrations of the elements of a 7-AAB panel were quantitated by enzyme-linked immunosorbent assay (ELISA) in 806 participants. The probability of MPNs was calculated using the Mayo predictive model. The performances of the 7-AAB panel and the Mayo model were analyzed by receiver operating characteristic (ROC) analyses, and the difference between groups was evaluated by chi-square tests ( χ 2 ). Results. The combined area under the ROC curve (AUC) for all 7 AABs was higher than that of a single one. The sensitivities of the 7-AAB panel were 67.5% in the stage I-II LC patients and 60.3% in the stage III-IV patients, with a specificity of 89.6% for the healthy controls and 83.1% for benign lung disease patients. The detection rate of the 7-AAB panel in the early-stage LC patients was higher than that of traditional tumor markers. The AUC of the 7-AAB panel in combination with the Mayo model was higher than that of the 7-AAB panel alone or the Mayo model alone in distinguishing MPN from benign nodules. For early-stage MPN, the sensitivity and specificity of the combination were 93.5% and 58.0%, respectively. For advanced-stage MPN, the sensitivity and specificity of the combination were 91.4% and 72.8%, respectively. The combination of the 7-AAB panel with the Mayo model significantly improved the detection rate of MPN, but the positive predictive value (PPV) and the specificity were not improved when compared with either the 7-AAB panel alone or the Mayo model alone. Conclusion. Our study confirmed the clinical value of the 7-AAB panel for the early detection of lung cancer and in combination with the Mayo model could be used to distinguish benign from malignant pulmonary nodules.

Non-surgical management of early-stage lung cancer

2017 ◽  
Author(s):  
Jim Brown ◽  
Neal Navani
Keyword(s):  
Lung Cancer ◽  
Early Stage ◽  
Pulmonary Nodules ◽  
The Elderly ◽  
Multidisciplinary Teams ◽  
Solitary Pulmonary Nodules ◽  
Early Stage Lung Cancer ◽  
Mortality And Morbidity ◽  
Inoperable Patient ◽  
Ablative Techniques

As low-dose computed tomography screening of ‘high-risk’ smokers is occurring with increasing frequency, the incidental discovery of solitary pulmonary nodules is becoming more frequent, and lung cancer multidisciplinary teams are now often faced with balancing risk and benefit when making decisions regarding the radical treatment of patients with a clinical diagnosis of early lung cancer but borderline fitness. Surgery offers the best prospect of cure but is associated with significant mortality and morbidity; the elderly and frail experience more toxicity and a greater impact on the quality of life. This chapter reviews the criteria for assessing surgical fitness and examines the evidence for minimally invasive and ablative techniques for the treatment of early peripheral lung cancer in the medically inoperable patient.

scholarly journals The role of race and economic characteristics in the presentation and survival of patients with surgically-resected non-small cell lung cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20053-e20053
Author(s):  
Kerri McKie ◽  
John M. Varlotto ◽  
Rick Voland ◽  
John Charles Flickinger ◽  
Malcolm M. DeCamp ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Ethnic Groups ◽  
Early Stage ◽  
Social Variables ◽  
Chi Square ◽  
Early Stage Lung Cancer ◽  
Lung Cancer Patients ◽  
Disease Biology ◽  
Younger Age ◽  
Multivariable Analyses

e20053 Background: To investigate the inter-relation between economic, marital, and known histopathologic/therapeutic prognostic factors in presentation and survival of surgically-resected lung cancer patients in nine different ethnic groups. Methods: A retrospective review of the SEER database was conducted through the years 2007-2012. Population differences were assessed via chi-square testing. Multivariable analyses(MVA) were used to detect overall survival(OS) differences in the total surgical population (TS, N = 35,689) and in an early-stage (T1-T2 < 4cm N0) surgically-resectable population(ESR, N = 17,931). Results: In the TS population, as compared to Whites, Blacks and Hispanics were more likely to present with younger age, adenocarcinomas, less married partnerships, no insurance, fewer stage I tumors, and fewer nodes examined, but their surgical procedure types and OS/LCSS were the same. MVA demonstrated that lower OS was associated with males, single/divorced/widowed partnership, lower income(TS only), and Medicaid insurance. MVA also found that all ethnic groups had a similar (Hispanics, Blacks) or better OS compared to Whites. 90-day mortality and positive nodes were correlated with not having insurance and not being married, but not ethnicity. Conclusions: In TS and ESR groups, OS was not different in the two largest ethnic groups (Black, Hispanic) as compared to Whites, but was related to single/widowed/divorced status, Medicaid insurance, and income (TS group only). Nodal positivity was associated with patients who did not have a married partner or insurance suggesting that psycho-social variables may impact disease biology in addition to the known histopathologic and treatment variables in patients undergoing surgical resection of early-stage lung cancer.

scholarly journals The Role of IGF-Pathway Biomarkers in Determining Risks, Screening, and Prognosis in Lung Cancer: A Systematic Review.

2021 ◽  
Author(s):  
Alexander W. Pohlman ◽  
Hita Moudgalya ◽  
Lia Jordano ◽  
Gabriela C. Lobato ◽  
David Gerard ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Early Stage ◽  
Pulmonary Nodules ◽  
Lung Cancer Screening ◽  
Smoking History ◽  
Early Stage Lung Cancer ◽  
Detection Rates ◽  
Variable Expression ◽  
Igf I ◽  
Igfbp 3

Abstract Background: Detection rates of early-stage lung cancer are traditionally low, which contributes to inconsistent treatment responses and the highest rates of annual cancer deaths in the U.S. Currently, age and smoking history are the primary factors that qualify patients for low-dose computed tomography (LDCT) screening, which contributes heavily to a high false discovery rate. This limitation to the current screening paradigm has prompted research to identify biomarkers that will help more clearly define eligible patients for LDCT screening, differentiate indeterminate pulmonary nodules, and select individualized cancer therapy. Biomarkers within the Insulin-like Growth Factor (IGF) family have come to the forefront of this research. Methods: Literature available through PubMed and Google Scholar sources was cataloged using keywords: {Lung Cancer} AND {IGF} AND {Risk OR Diagnosis OR Prognosis OR Prognostication OR Treatment}. The results were summarized and provided herein.Results: Multiple biomarkers within the IGF family (or axis) have been investigated, most notably IGF-I and IGF binding protein 3 (IGFBP-3). However, newer studies seek to expand this search to other molecules within the IGF axis. Results have differed, however, due to features such as the pre-disease variable expression of IGF-I and IGFBP-3, likely promoted by factors such as obesity and smoking history. Certain studies have demonstrated these biomarkers are useful as a companion test alongside lung cancer screening, but other findings were not as conclusive, possibly owing to measurement bias from pre-analytical variables and non-standardized assay techniques. Research also has suggested IGF biomarkers may be beneficial in the prognostication and subsequent application of treatment via systemic therapy. Despite these advances, however, additional knowledge as to the intricacies of regulatory mechanisms inherent to this system are necessary to more fully harness the potential clinical utility for diagnostic tests and to identify novel targets for therapeutic intervention. Conclusions: The IGF system likely plays a role in multiple phases of lung cancer; however, there is a surplus of conflicting data, especially prior to development of the disease and during early stages of detection. IGF biomarkers may be valuable in the screening, prognosis, and treatment of lung cancer, though their exact application requires further study.

scholarly journals Does aggressive management of solitary pulmonary nodules pay off?

Breathe ◽  
2019 ◽  
Vol 15 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Stefano Elia ◽  
Serafina Loprete ◽  
Alessandro De Stefano ◽  
Georgia Hardavella
Keyword(s):  
Lung Cancer ◽  
Minimally Invasive ◽  
Early Stage ◽  
Large Diameter ◽  
False Negative ◽  
Pulmonary Nodules ◽  
Solitary Pulmonary Nodules ◽  
Early Stage Lung Cancer ◽  
Fdg Uptake ◽  
Negative Results

Indeterminate solitary pulmonary nodules (SPNs), measuring up to 3 cm in diameter, are incidental radiological findings. The ever-growing use of modern imaging has increased their detection. The majority of those nodules are benign; however, the possibility of diagnosing early-stage lung cancer still stands. Guidelines for the management of SPNs have never been validated in prospective comparative studies.Positron emission tomography (PET) is a useful tool to provide functional information on SPNs. However, overall sensitivity and specificity of PET in detecting malignant SPNs of at least 10 mm in diameter are about 90% and false-negative results are reported.The development of video-assisted thoracic surgery has provided minimally invasive diagnosis and treatment of SPNs. In our series, 105 patients underwent surgery based on combined increased18F-labelled 2-fluoro-2-deoxy-d-glucose (FDG) uptake on PET computed tomography and radiological features (morphology and density) without prior histological confirmation. We detected 26 false negatives (24.8%) and only nine false positives (8.57%). Therefore, our minimally invasive surgical approach prevented 25% of patients with lung cancer from a delayed treatmentversusonly 9% undergoing “overtreatment”.In our monocentric cohort, patients with SPNs with large diameter, irregular outline, no calcifications, central location, increased FDG uptake and/or subsolid aspect benefited from a primary surgical resection.

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