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Q.K.K. Li
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P2.06 - Poster Session/ Screening and Early Detection (ID 219)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.06-020 - Comparison of Cytological Diagnosis Between Solitary and Semi-Solitary Lung Nodules in Biopsy Samples: Experience from a Single Academic Center (ID 769)
09:30 - 09:30 | Author(s): Q.K.K. Li
- Abstract
Background:
The recent large scale National Lung Cancer Screening Trial in the United States (NLST) demonstrated an increased detection of stage I lung cancers. This approach was associated with a 20% reduction of lung cancer-related deaths in the screening population. However, the current clinical guideline for the management of lung nodule is primarily based on studies of non-calcified solitary pulmonary nodules (SPN). Although several recent studies have addressed the issue of the management of semi-solitary and/or partially calcified lung nodules, the evidence-based study is still necessary. Clinically, the diagnosis of small pulmonary nodules involves the combination of radiological surveillance and the morphological examination of pulmonary cells, such as bronchoscopic sampling of the lesion, including bronchial brushing and/or transbronchial fine needle aspiration biopsy (TBNA) with or without ultrasound guidance. In this study, we correlated cytomorphological diagnoses of lung nodules with radiological characteristics, and compared them with findings of mediastinal lymph nodes (LN) fine needle aspiration (FNA) biopsy.
Methods:
A total of 300 lung and mediastinal LN cases over a one-year period were identified by a computer search, including 117 lung and 183 lymph nodes biopsies. All cases were divided into three categories: solitary, semi-solitary and partially calcified nodules/lesions according to radiographic image. The cytological diagnoses of all cases were correlated with radiographic findings.
Results:
In lung biopsies, the average sizes of the solitary, semi-solitary and calcified lesions were 1.952+/-2.225, 1.333+/-1.827, and 1.152+/-1.984 cm, whereas, in lymph nodes the average sizes of the solitary, semi-solitary and calcified lesions were 1.696+/-2.225, 0.909+/-1.041, and 2.788+/-3.371 cm. The cytological diagnosis was summarized in the table.Lesions Lung (n=117) Lymph node (n=183) Malignant Benign Suspicious Malignant Benign Suspicious Solitary (lung n=88) (LN n=156) 58 (65.9%) 23 (26.1%) 7 (8.0%) 136 (87.2%) 20 (12.8%) 0 Semi-solitary (Lung n=23) (LN n=23) 8 (34.8%) 12 (52.2%) 3 (13.4%) 21 (91.3%) 2 (8.7%) 0 Calcified (Lung n=6) (LN n=4) 2 (33.3%) 3 (50%) 1 (16.7%) 4 (100%) 0 0 Total 68 (58.1%) 38 (32.5%) 11 (9.4%) 161 (88%) 22 (12%) 0
Conclusion:
In suspicious solitary and semi-solitary lung nodules, the malignancy was diagnosed as 65.9% and 34.8%, respectively. In suspicious solitary and semi-solitary lymph nodes, the malignancy was diagnosed as 87.2% and 91.3%, respectively. In lung lesions with partial calcifications (we only had very limited number of cases), approximately 50% were malignant lesions. In addition to radiological evaluation, the cytomorphological evaluation of semi-solitary and partially calcified nodules is still crucial for the accurate diagnosis and the appropriate clinical management of lung nodules patients.
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P3.06 - Poster Session/ Screening and Early Detection (ID 220)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.06-007 - Discovery and Validation of Potential Glycoprotein Biomarkers in the Airway Fluid to Improve the Detection of Lung Cancer from Benign Lung Nodule (ID 925)
09:30 - 09:30 | Author(s): Q.K.K. Li
- Abstract
Background:
Recent clinical screening trials using highly sensitive low-dose computed tomography (LDCT) demonstrated an increased detection proportion of stage I lung cancers and improved overall survival of lung cancer patients as the result of early detection. However, lung cancer screening trials also showed high repeat screening rates and false-positive rates causing unnecessary second-line invasive procedures and surgery. New strategies are still needed to improve the specificity of lung cancer screening. The airway fluid, bronchoalveolar lavage (BAL), is commonly used for the evaluation of lung nodules and diagnosis of lung cancers. Proteins in the BAL fluid may serve as potential biomarkers for cancer detection. In this study, we examined the protein profile, particularly the signature of glycoprotein in normal and lung cancer patients.
Methods:
We collected BAL fluid after cellular components were harvested for cytological examination in the cytology laboratory. Protein profile and N-glycoproteins were analyzed using the solid-phase extraction of N-glycoprotein (SPEG) and liquid chromatography tandem mass spectrometry (LC-MS/MS). Sixteen BAL samples, including four cases each of benign lung disease, adenocarcinoma (ADC), squamous cell carcinoma (SqCC), and small cell carcinoma (SCLC), were analyzed.
Results:
A total of 1013 unique peptides from 457 glycoproteins were identified and quatified. Among them, 286 proteins were identified in BAL of ADC, 363 in squamous cell carcinoma (SqCC), 298 in SCLC and 330 in benign BALs. In addition to common proteins found in all groups, we identified 113 unique proteins that were differentially expresssed in benign disease, ADC, SqCC and SCLC, respectively. The levels of Napsin A, periostin, Galectin-3-binding protein (G3-BP) and myeloperoxidase (MPO) in cancer and benign BALs were further validated using independently collected BAL specimens by ELISA assays (Table 1). Table1. Detection of Proteins in BAL from lung cancer and benign lung disease by ELISA assays.
* protein concentration was expressed as ng/mg total BAL protein. ** for benign lesions.Protein Benign* (n=7) ADC* (n=18) SqCC* (n=9) SCLC* (n=6) Sensitivity (%) Specificity (%) PPV (%) NPV (%) P value Napsin A 55±39 295±104 102±34 50±28 83.3 66.7 88.2 57.1 <0.05 Periostin 255±104 4002±218 3496±1765 1772±1119 73.68 71.43 87.5 50.0 <0.05 G3-BP 168±29 290±70 240±65 132±65 47.4 11.8% 69.2 23.1 >0.05 MPO 3227±2948 0.08±0.03 1.6±0.7 0.1±0.06 33.3 100 100 83.3 <0.05**
Conclusion:
Our study demonstrates that potential protein biomarkers in BAL fluid can be identified and quantified. They have the potential to improve the specificity of lung screening tests and to reduce unnecessary surgery in patients with benign lung nodules.
