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M. Huang
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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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P1.03-074 - Combined Use of PET/CT and Clinical Features Yields a Higher Diagnostic Rate of Mediastinal Lymph Node Metastasis in Lung Adenocarcinoma (ID 4936)
14:30 - 14:30 | Author(s): M. Huang
- Abstract
Background:
The aims of this study were to investigate the correlation between [8]F-fluorodeoxyglucose (FDG) uptake of the primary tumor and mediastinal lymph node metastasis (MLNM) in lung adenocarcinoma, and to improve the diagnostic capability of tumor FDG uptake and other risk factors in predicting occult MLNM preoperatively.
Methods:
We reviewed 360 consecutive pulmonary adenocarcinoma patients who underwent preoperative PET/CT scan and subsequent surgery. Resected tumors were classified according to the 2011 IASLC/ATS/ERS classification. Univariate and multivariate analysis were conducted to evaluate the associations between clinicopathological variables and MLNM. The receiver operating characteristic (ROC) curve analysis was performed to quantify the predictive value of these factors.
Results:
Of all the 360 patients, 54 were pathological N2 diseases. On univariate analysis, CEA level, nodule type, nodal SUVmax, tumor SUVmax, size, location and histologic subtype were associated with MLNM. On multivariate analysis, CEA≥5.0 ng/ml (p < 0.001), solid nodule (p = 0.012), tumor SUVmax ≥ 3.7 (p < 0.027), nodal SUVmax ≥ 2.0 (p < 0.001) and centrally located tumors (p = 0.035) were independent risk factors that associated with MLNM. The area under the ROC curve (AUC) for tumor SUVmax in predicting MLNM was 0.764 and AUC of nodal SUVmax was 0.730. The combined use of five factors yielded a higher AUC of 0.885 for N2 disease. The tumor SUVmax among histologic subtypes differed significantly (p < 0.001).
Conclusion:
Primary tumor SUVmax of PET/CT was shown a good predictor for MLNM in patients with lung adenocarcinoma, and the underlying mechanism may attribute to the close association between tumor FDG uptake and IASLC/ATS/ERS adenocarcinoma subtypes. The combined use of tumor SUVmax with factors like nodal SUVmax, solid nodule, centrally located tumor and increased CEA level improved the diagnostic capacity for predicting N2 disease preoperatively.
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P2.02 - Poster Session with Presenters Present (ID 462)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Locally Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.02-004 - Real-time Monitoring of Circulating Tumor Cells to Evaluate Response of Neoadjuvant Chemotherapy in Locally Advanced NSCLC (ID 4927)
14:30 - 14:30 | Author(s): M. Huang
- Abstract
Background:
Enumeration and karyotyping of circulating tumor cells (CTCs) in therapeutic cancer patients is of particular clinical significance. The aim of this study is to evaluate therapeutic effect of neoadjuvant chemotherapy (NAC) by means of real-time monitoring of CTCs in locally advanced non-small cell lung cancer (NSCLC).
Methods:
Real-time monitoring of CTCs in the course of 2 cycles of platinum-based NAC was conduct in 34 locally advanced NSCLC patients. The integrated subtraction enrichment and immunostaining fluorescence in situ hybridization (SE-iFISH) method was applied to detect and characterize CTCs in peripheral venous blood. Chest CT was used to evaluate therapeutic response with RECIST 1.1 as the evaluation criterion.
Results:
Of the 34 patients enrolled, 13 acquired partial response (PR) and 21 were stable diseases (SD) after NAC. The numbers of CTCs were found decrease in 70% of PR patients and only 25% of SD patients. The changes of CTC count were significantly different between PR and SD group (p=0.009). The positive rate of CTCs with triploidy of chromosome 8 increased after 2 cycles platinum-based NAC, and the elevation was even more remarkable in SD group.
Conclusion:
The changes of CTC count after NAC were in accordance with CT responses. Triploidy of chromosome 8 CTC was correlated with primary resistance to platinum-based chemotherapy. Real-time monitoring of CTC count and karyotype may be of clinical value in rapid evaluation of therapeutic effect and monitoring occurrence of chemo-resistance.
