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H. Wang
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P1.03 - Poster Session with Presenters Present (ID 455)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Radiology/Staging/Screening
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.03-062 - Lung Cancer Screening with Low-Dose CT in China: Study Design and Baseline Results from the First Round Screening Arm (ID 5639)
14:30 - 14:30 | Author(s): H. Wang
- Abstract
Background:
Lung cancer screening with low-dose CT (LDCT) was shown to reduce lung cancer mortality by 20% in the National Lung Screening Trial. However, several other trails have reported that there was no reduction in lung cancer mortality with a LDCT screening strategy. Meanwhile, whether LDCT screens could decrease healthcare costs is yet insufficiently explored. The objectives of the present study was to investigate whether LDCT screening is capable to reduce the lung cancer mortality by at least 20% and analyze the healthcare costs of the lung cancer LDCT screening in China.
Methods:
The present study is a randomized controlled trial of LDCT screening for lung cancer versus usual care. Eligible participants were those aged 45–70 years, and with either of the following risk factors: 1) history of cigarette smoking ≥ 20 pack-years, and, if former smokers, had quit within the previous 15 years; 2) malignant tumors history in immediate family members; 3) personal cancer history; 4) professional exposure to carcinogens; 5) long term exposure to second-hand smoke; 6) long term exposure to cooking oil fumes. All the participants were randomized into a screening arm with three rounds of alternate years LDCT screens and a control arm with three rounds of alternate years questionnaire inquiries. Management of positive screening test was carried out by a prespecified protocol.
Results:
From November 2013 to November 2014, 5933 participants were enrolled in our trail, of which 2933 were assigned to LDCT screening arm, and 3000 to control arm. In the first screening round, 2892 participants (98.6%) undergo LDCT after randomization. At baseline 742 subjects (25.7%) showed noncalcified nodules (NCN) larger than 4 mm. 69 cases were highly suspected of lung cancer according to the suggestion of three experienced experts. The highly suspected cases were accounting for 9.30% of all NCN subjects and 2.39% of all the screening arm participants. By March 2016, 26 cases underwent surgical resections, including 23 lung adenocarcinoma, 1 lung squamous cell carcinoma and 2 benign lesions, representing a positive lung cancer detection rate with low-dose CT screening of 0.83%(24/2892). Among all the lung cancer cases, 23/24 (95.8%) had stage I disease, and 1/24 (4.2%) had stage II disease. The second round screening was still ongoing since May 2016.
Conclusion:
Screening with LDCT increases the detection rate of early stage lung cancers (stage I and II) in a high risk population.
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P1.05 - Poster Session with Presenters Present (ID 457)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Early Stage NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.05-019 - Two Inflammatory Biomarkers MDC/CCL22 and BLC/CXCL13 Are Independently Associated with the Significant Risk of Early Stage Lung Adenocarcinoma (ID 3966)
14:30 - 14:30 | Author(s): H. Wang
- Abstract
Background:
This prospective study was designed to investigate the association between multiple inflammatory biomarkers in circulation and the risk for early stage lung adenocarcinoma.
Methods:
We measured 10 inflammatory biomarkers in 228 early stage lung adenocarcinoma patients and 228 age, sex and smoking matched healthy controls by using the Luminex bead-based assay.
Results:
Only two biomarkers were significantly associated with early stage lung adenocarcinoma risk after Bonferroni correction: the multivariate odd ratio or OR (95% confidence interval or CI) was 0.29 (0.16-0.53) for MDC/CCL22 (P<0.0001) and 4.17 (2.23-7.79) for BLC /CXCL13 (P<0.0001) for the comparison of 4[th] quartile with 1[st] quartile. When analysis was restricted to never smokers (196 patients/196 controls), MDC/CCL22 and BLC/CXCL13 were still significantly associated with early stage lung adenocarcinoma risk (OR; 95% CI; P: 0.37; 0.21-0.66; P<0.0001 for MDC/CCL22 and 2.78; 1.48-5.22; P =0.001 for BLC/CXCL13). Additionally, significance persisted after restricting analysis to 159 stage IA lung adenocarcinoma patients and 159 matched controls for MDC/CCL22 (OR; 95% CI; P: 0.37; 0.21-0.66; <0.0001) and BLC/CXCL13 (2.78; 1.48-5.22). Furthermore, elevated BLC/CXCL13 was associated with a 2.90-fold (95% CI: 1.03-8.17; P=0.037) increased risk of subcentimeter lung adenocarcinoma, and there was an increasing trend for BLC/CXCL13 with the progression of subcentimeter lung adenocarcinoma.
Conclusion:
Our findings demonstrated that MDC/CCL22 and BLC/CXCL13 were independently associated with the significant risk of early stage lung adenocarcinoma, and this association persisted even in non-smokers and in stage IA patients. Moreover, BLC/CXCL13 was identified to play a carcinogenic role in the progression of lung adenocarcinoma.
