High preoperative and postoperative levels of carcinoembryonic antigen and CYFRA 21‑1 indicate poor prognosis in patients with pathological Stage I nonsmall cell lung cancer.

BACKGROUND: Serum carcinoembryonic antigen (CEA) and the soluble fragment of cytokeratin 19 (CYFRA 21‑1) are supposed to have a prognostic role in patients with nonsmall cell lung cancer (NSCLC) after surgery, but it has not been used as an adjunct to the tumor‑node‑metastasis (TNM) staging system to provide therapy options for patients with pathological Stage I NSCLC. This study was designed to investigate the effect of serum levels of CEA and CYFRA 21‑1 before and after surgery on the prognosis of patients with Stage I NSCLC. MATERIALS AND METHODS: A retrospective review was performed regarding the medical records and follow‑ups of 169 patients with Stage I NSCLC before and after surgery. The patients were divided into three groups based on levels of serum CEA and CYFRA 21‑1 before and after surgery: (1) continuously normal‑level groups (CEA [NN] and CYFRA 21‑1 [NN] groups); (2) declined to normal‑level groups (CEA [HN] and CYFRA 21‑1 [HN] groups); and (3) continuously high‑level groups (CEA [HH] and CYFRA 21‑1 [HH] groups). Survival analysis was conducted using the Kaplan–Meier method for each group. The Chi‑square or Fisher exact test was employed to compare clinical and pathologic factors at the level of P < 0.05. The prognostic factor was evaluated by the Cox proportional hazards model. RESULTS: Compared with the continuously normal‑level groups, the CEA [HN] group was significantly correlated to tumor size (P = 0.011), and the CYFRA 21‑1 [HN] group was significantly correlated to tumor type and pathological TNM in addition to tumor size. Five‑year survivals were significantly lower (P = 0.004) in the CEA [HH] group (67.3%) and the CEA [HN] group (86.5%) than in the CEA [NN] group (85.7%) and were significantly lower (P < 0.001) in the CYFRA 21‑1 [HH] group (47.2%) and the CYFRA 21‑1 [HN] group (70.1%) than in the CYFRA 21‑1 [NN] group (90.1%). Multivariate analysis demonstrated that tumor size (21–50 mm), CEA [HH], and CYFRA 21‑1 [HH] were independent unfavorable prognostic factors for overall survival (OS), whereas tumor size (21–50 mm), CEA [HH], CYFRA 21‑1 [HN], and CYFRA 21‑1 [HH] were independent significant prognostic factors for progression‑free survival (PFS). CONCLUSION: Patients with a persistently high serum CEA or CYFRA 21‑1 before and after surgery had shortest OS and PFS. These patients had worst prognosis. Adjuvant chemotherapy was likely to improve survival for these patients.

Predictive significance of standardized uptake value parameters of FDG-PET in patients with non-small cell lung carcinoma

18F-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is widely used to diagnose and stage non-small cell lung cancer (NSCLC). The aim of this retrospective study was to evaluate the predictive ability of different FDG standardized uptake values (SUVs) in 74 patients with newly diagnosed NSCLC. 18F-FDG PET/CT scans were performed and different SUV parameters (SUVmax, SUVavg, SUVT/L, and SUVT/A) obtained, and their relationship with clinical characteristics were investigated. Meanwhile, correlation and multiple stepwise regression analyses were performed to determine the primary predictor of SUVs for NSCLC. Age, gender, and tumor size significantly affected SUV parameters. The mean SUVs of squamous cell carcinoma were higher than those of adenocarcinoma. Poorly differentiated tumors exhibited higher SUVs than well-differentiated ones. Further analyses based on the pathologic type revealed that the SUVmax, SUVavg, and SUVT/L of poorly differentiated adenocarcinoma tumors were higher than those of moderately or well-differentiated tumors. Among these four SUV parameters, SUVT/L was the primary predictor for tumor differentiation. However, in adenocarcinoma, SUVmax was the determining factor for tumor differentiation. Our results showed that these four SUV parameters had predictive significance related to NSCLC tumor differentiation; SUVT/L appeared to be most useful overall, but SUVmax was the best index for adenocarcinoma tumor differentiation.

A multiplex touchdown PCR for detection of Streptococcus pneumoniae, Haemophilus influenzae type b and Mycobacterium tuberculosis complex in sputum samples

Rapid and accurate detection of Streptococcus pneumoniae (Sp), Haemophilus influenzae type b (Hib) and Mycobacterium tuberculosis complex (MTBC) in sputum by conventional methods remains problematic. Primers based on capsular polysaccharide biosynthesis gene (cpsA), the region II of the capsulation locus (cap), the insertion sequence IS6110 were designed for Sp, Hib, MTBC respectively. These primers were incorporated in a multiplex touchdown PCR assay for simultaneous detection of Sp, Hib and MTBC. The multiplex touchdown PCR assay was evaluated using standard strains and clinical sputum samples. The multiplex touchdown PCR assay showed 100% specificity in identifying Sp, Hib, MTBC from pure culture of standard strains. The sensitivities of the multiplex touchdown PCR assay were 94%, 98%, 98% for detection of Sp, Hib and MTBC respectively based on culture results while evaluated using 492 consecutive qualified clinical sputum samples; the specificities were all 100%. This highly sensitive and specific multiplex touchdown PCR assay offers a rapid and simple method for detection of Sp, Hib and MTBC in clinical sputum samples.