Standardized uptake valuemax of the primary lesion combined with tumor markers for clinically predicting distant metastasis in de novo lung adenocarcinoma.

BACKGROUND: To examine standardized uptake valuemax of the primary lesion (pSUVmax) and tumor markers (TMs) for clinically predicting distant metastasis in novo lung adenocarcinoma. METHODS: The current retrospective observational study examined individuals diagnosed with de novo lung adenocarcinoma at Shanxi Cancer Hospital between February 2015 and December 2019. RESULTS: Totally, 532 de novo lung adenocarcinoma cases were included. They were aged 60.8 ± 9.7 years and comprised 224 women and 268 patients with distant metastasis. The areas under the curves (AUCs) of pSUVmax, lactate dehydrogenase (LDH), carcinoembryonic antigen (CEA), cytokeratin-19 fragment (CYFRA21-1), carbohydrate antigen 125 (CA125), and Grade of TMs for predicting distant metastasis were 0.742, 0.601, 0.671, 0.700, 0.736, and 0.745, respectively. The combination of pSUVmax, LDH, CEA, CYFRA21-1, CA125, and grade of TMs in predicting distant metastasis had an AUC value of 0.816 (95%CI: 0.781-0.851), with sensitivity of 89.2%, specificity of 58.7%, positive predictive value of 73.7%, and negative predictive value of 79.7%, respectively. CONCLUSIONS: pSUVmax combined with serum levels of LDH, CEA, CYFRA21-1, CA125, and the grade of TMs may have good performance in predicting distant metastasis of de novo lung adenocarcinoma.

Significance of thyroid transcription factor 1 and Napsin A for prompting the status of EGFR mutations in lung adenocarcinoma patients.

Background: To evaluate the prompting value of thyroid transcription factor 1 (TTF-1) and Napsin A for the status of epidermal growth factor receptor (EGFR) mutations in an independent cohort of lung adenocarcinomas (LUADs) when genetic testing is unavailable. Methods: In this study, 976 untreated primary LUADs were retrospectively reviewed. The clinical and pathological data, including age, gender, smoking history, predictive values of TTF-1 and Napsin A, EGFR status, and tumor-node-metastasis (TNM) stage were obtained through medical records available in Shanxi Province Cancer Hospital. All patients were divided into 2 groups, a mutant group (n=362) and wild-type group (n=614), according to their EGFR status. The clinical data and the expression of TTF-1 and Napsin A were compared between the 2 groups. TTF-1 and Napsin A are detected by fully automated IHC.PCR was carried out to detect the EGFR mutation. Univariate and multivariate logistic regression analyses were undertaken to distinguish independent factors of EGFR mutations. Results: A total of 362 cases (37.1%) of EGFR mutations were detected, which were more frequent in females, never smokers, lymphatic metastasis, distant metastasis, and the positive expression of TTF-1 and Napsin A. Multivariate analysis indicated that females [odds ratio (OR), 1.950; 95% confidence interval (CI): 1.2958 to 2.938; P=0.001], never smokers (OR, 2.040; 95% CI: 1.345 to 3.094; P=0.001), and the positive expression of TTF-1 (OR, 2.366; 95% CI: 1.440 to 3.887; P=0.001) and Napsin A (OR, 2.295; 95% CI: 1.448 to 3.638; P<0.001) were effective prompting for EGFR mutations. Conclusions: The positive expression of TTF-1 and Napsin A had the prompting value for EGFR mutations in patients with LUAD, and the indicators could be combined with other clinical characteristics to enhance the prediction of the EGFR status in LUAD.

Prognostic role of epidermal growth factor receptor mutation status in patients with de novo lung adenocarcinoma.

BACKGROUND: To explore the relationship between the status of epidermal growth factor receptor (EGFR) and overall survival (OS) in de novo lung adenocarcinoma. METHODS: We retrospectively analyzed 291 lung adenocarcinoma subjects with exact EGFR status. The cases were divided into a mutant-type group (124 patients) and wild-type group (167 patients) according to the status of EGFR. The general information, OS, and possible risk factors influencing the OS were also evaluated. RESULTS: The EGFR mutation rate was 42.6% (124/291 patients), and there were statistically significant differences in gender, smoking history, and OS (P<0.05), but no significant difference in diagnosed age, alcohol history, TNM stage, clinical stage, and immunohistochemistry between the two groups (P>0.05). The most common subtypes of EGFR mutations were exon 19 and exon 21. The median OS of the total population was 30.20 months [95% confidence interval (CI): 25.94-34.46 months] and the OS in the mutant-type group was better than in the wild-type group (P<0.001). Cox regression demonstrated that N stage, M stage, and EGFR status were the risk factors for OS in de novo lung adenocarcinoma patients (P<0.001), and the relative risk were 1.398 (95% CI: 1.214-1.609), 2.427 (95% CI: 1.780-3.310), and 2.030 (95% CI: 1.528-2.699), respectively. CONCLUSIONS: The OS of EGFR mutant individuals was better than that of wild-type patients in de novo lung adenocarcinoma patients. EGFR mutation may be a useful prognostic indicator in lung adenocarcinoma.