Author of

• 20170

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  P2.06 - Epidemiology/Primary Prevention/Tobacco Control and Cessation (ID 707)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Epidemiology/Primary Prevention/Tobacco Control and Cessation
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23370

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    P2.06-006 - Screening Values of CEA and Cyfra 21-1 for Lung Cancer in Combination with Low Dose CT (LDCT) in High-Risk Populations (ID 9340)

    09:30 - 09:30  |  Author(s): J. Patumanond
    • Abstract
    • Slides

    Background:
    Lung cancer screening with low-dose CT (LDCT) decreased lung cancer mortality. However, its major limitation for high false positive rate was concerned. Tumor markers in combination with LDCT may increase its screening value for lung cancer.
    
    Method:
    In this prospective LDCT screening study, we enrolled subjects who were former or current heavy smokers (>30 pack-years) aged 50-70 years. The LDCT screening results were classified as negative, indeterminate, or positive (suspicious for primary lung cancer) based on the probability for lung cancer, mainly focused on nodule size and opacity at baseline LDCT and new or nodule growth at the follow-up LDCT. Serum CEA and Cyfra 21-1 were taken only from subjects with indeterminate and positive LDCT result with a cut-off level of 5 ng/ml and 4 ng/ml, respectively. These markers were followed with LDCT at least once a year. Positive tumor marker was defined as an abnormal level of either CEA or Cyfra 21-1.
    
    Result:
    Among 634 high risk subjects investigated, there were 70 subjects who had indeterminate LDCT and 22 subjects who had positive LDCT at initial screening cycle. A total of 17 lung cancer cases were diagnosed in 2 years, 9 from initial screening and 8 from follow-up cycles. The likelihood ratio of positive (LHR+) for lung cancer diagnosed in 12 months with positive tumor marker was 6.61 (p=0.003) among subject with indeterminate baseline LDCT, and 1.51 (p=0.670) among those with negative. LHR+ for lung cancer diagnosed after 24-month follow up was 6.31 (p<0.001) and 0.86 (p=0.881) respectively. The LHR+ for lung cancer diagnosed in 12 months among subjects with positive baseline LDCT, with positive and negative tumor marker was 69.44 (p<0.001) and 11.57 (p=0.015), respectively. The corresponding LHR+ for 24-month cancer was 13.61 (p<0.001) and 18.15 (p<0.001), respectively.The crude AuROC of parallel CEA/Cyfra 21-1 & LDCT and of CEA & LDCT for lung cancer screening in combination with LDCT were significantly higher than LDCT alone (0.76 VS 0.68, p=0.033 and 0.75 VS 0.68, p=0.038, respectively). The AuROC was also significantly higher after adjusted for age & smoking status (0.84 VS 0.80, p=0.019, and 0.84 VS 0.80, p=0.029, respectively)
    
    Conclusion:
    CEA in combination with LDCT significantly increased values for lung cancer screening in high-risk populations than using LDCT alone particularly in participants in patients with indeterminate baseline LDCT.
    
    

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