The value of human epididymis protein 4 (HE4) as a serum tumor marker for accurate bone metastases finding by whole-body bone scintigraphy in lung cancer patients

Backgrounds: There is a subclinical activation of coagulation and ﬁbrinolysis system in patient with lung cancer. Alterations in hemostatic system are seen frequently in lung cancer correlated with the prognosis of disease. In oncology practice, the use of tumor markers may be helpful in the diagnosis and pathologic classification of tumors. Tumor marker may reflect both, stage of the disease and prognosis. Aim of this research is to asses the correlation of this parameters in patient non-small cell lung cancer with chemotherapy. Methods: This research is an analytic observational with a cross sectional design. The research was conducted at RSUP Haji Adam Malik, Medan from January 1, 2015 to May 31, 2016. Blood test examination was performed to measure the hemostatic parameter (PT, INR, APTT, TT, D-dimer) and serum tumor marker (CEA, Cifra21-1, NSE) of 41 non-small cell lung cancer patients before first cycle of chemotherapy and after fourth or sixth cycles of chemotherapy. Results: The study comprised 41 patients of non-small cell lung cancer (31 adenocarcinoma, 10 squamous cell carcinoma), There were 35 men (85,4%) and 3 women (14,6%) with mean age of 56,7 years. For all patients, we give a platinum based therapy as first line chemotherapy (gemsitabine and carboplatin regimen in 27 patients, paclitaxel and carboplatin in 10 patients, vinorelbine and carboplatin in 4 patients). There is no significant difference of hemostatic parameter and serum tumors marker values before chemotherapy againts after chemotherapy values. And there is a weak negative correlation of hemostatic parameter againts serum tumor marker on non-small cell lung cancer patients with chemotherapy. Conclusion: There is a weak negative correlation of hemostatic parameter againts serum tumor marker in non-small cell lung cancer patients with chemotherapy. (J Respir Indo 2018; 38(1): 33-38)

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Can PET/CT substitute for bone scintigraphy in assessment of bone metastases in lung cancer patients?

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.7203 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 7203-7203

Author(s):

H. Watanabe ◽

S. Monzawa ◽

S. Adachi ◽

A. Hamanaka ◽

Y. Kitamura ◽

...

Keyword(s):

Lung Cancer ◽

Bone Metastases ◽

Cancer Patients ◽

Bone Scintigraphy ◽

False Positive ◽

Gold Standard ◽

Ct Imaging ◽

Whole Body ◽

Lung Cancer Patients ◽

Pet Ct

7203 Background: Bone is a frequent site of lung cancer metastasis. However, false positive lesions detected by conventional bone scintigraphy often become problematic. We compared the efficacy of whole-body [18F]-2-Fluoro-2-deoxy- D- glucose PET/CT imaging and conventional bone scintigraphy for assessment of bone lesions in lung cancer patients on an individual patient basis. Methods: The study population comprised 106 consecutive patients with suspected or proven lung cancer (73 men and 33 women; age range: 40 to 85 years) who underwent both whole-body PET/CT imaging and conventional bone scintigraphy using 740 MBq of Tc-99m hydroxymethylene diphosphonate for cancer staging. Diagnostic radiologists interpreted and assessed all images on a patient-by-patient basis. Clinical information and the findings of follow-up imaging studies were used as the gold standard for the identification of bone metastases. Results: On the basis of the gold standard, 11 of the 106 patients were identified as having bone metastases. Bone scintigraphy showed a sensitivity of 67% (7/11) while that of PET/CT was 100% (11/11) for detection of bone metastases. Seven of these 11 patients were deemed positive based on both bone scintigraphy and PET/CT. Bone metastases not identified on bone scintigraphy were detected on PET/CT in another four patients. For 39 of 95 patients without bone metastases, the assessment was false-positive for bone scintigraphy but negative for PET/CT. In two of the 39 patients, CT images of PET/CT could identify a benign fracture causing a false positive finding for bone scintigraphy. Conclusions: PET/CT might actually substitute for bone scintigraphy in lung cancer patients because of its superior ability to detect unsuspected bone metastases and to differentiate bone metastases from false positive lesions detected by bone scintigraphy. No significant financial relationships to disclose.

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