ABSTRACT
Primary pulmonary enteric adenocarcinoma (PEAC) is a rare subtype of primary lung adenocarcinoma. However, it is not known whether there are any distinctive clinical or molecular features.PEACs were retrospectively identified in 28 patients from July 2014 to June 2016. We compared the clinicopathological, radiographic, and oncogenic characteristics of PEAC and primary pulmonary invasive adenocarcinoma (IAC).A total of 28 PEAC patients and 92 IAC patients were compared. PEAC occurred more frequently in males (Pâ=â.008), in older patients (Pâ=â.041), in those with larger lesions (Pâ=â.001), and in those in a more advanced stage (Pâ=â.011). Radiologically, PEAC patients had larger lesions (Pâ=â.025) and more solid (Pâ=â.006); however, there were no statistically significant differences in lobulation, spiculation, pleural indentation, pleural effusion, and lymphadenopathy between PEAC and IAC. PEAC had higher values of carcinoembryonic antigen (Pâ=â.008) and carbohydrate antigen 19-9 (Pâ<â.001) than IAC. PEAC had a higher incidence (40% vs 63%, Pâ<â.001) of Kristen rat sarcoma viral oncogene homolog (KRAS) mutations and a lower incidence (10.71% vs 3.3%, Pâ<â.001) of epidermal growth factor receptor (EGFR) mutations. Villin may be a useful marker in the differential diagnosis of PEAC. KRAS mutations occurred more frequently in PEACs, which are cytokeratin 7-negative (Pâ=â.032). EGFR mutation rates were higher in PEACs, which are cytokeratin 20- and caudal type homeobox transcription factor 2-negative (Pâ=â.041).PEAC is a rare and heterogeneous nonsmall-cell lung cancer subgroup with distinctive clinicopathological, radiographic, and molecular features. These results need to be further confirmed in future studies.
Subject(s)
Adenocarcinoma , Colonic Neoplasms/diagnosis , ErbB Receptors/genetics , Lung Neoplasms , Lung , Microfilament Proteins/analysis , Neoplasm Metastasis/diagnosis , Proto-Oncogene Proteins p21(ras)/genetics , Adenocarcinoma/diagnosis , Adenocarcinoma/genetics , Adenocarcinoma/pathology , Adenocarcinoma of Lung , Aged , Biomarkers/analysis , Carcinoembryonic Antigen/analysis , Colonic Neoplasms/pathology , Diagnosis, Differential , Female , Humans , Lung/diagnostic imaging , Lung/pathology , Lung Neoplasms/diagnosis , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Male , Middle Aged , Neoplasm Invasiveness , Statistics as Topic , Tomography, X-Ray Computed/methodsABSTRACT
Chest radiograph performed in a 61-year-old woman to evaluate cough showed a large mass in the right lung. On chest CT images, the mass was measured approximately 8.5 cm. Malignancy was considered, and bone scintigraphy was performed to assess possible osseous metastases. The bone scan images demonstrated increased tracer uptake by the lung mass. The mass was surgically resected, and the pathologic examination confirmed the rare diagnosis of a malignancy solitary fibrous tumors of the pleura.
Subject(s)
Solitary Fibrous Tumor, Pleural/diagnostic imaging , Bone and Bones/diagnostic imaging , Female , Humans , Middle Aged , Radiography, Thoracic , Radionuclide Imaging , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: This systemic analysis was conducted to to evaluate the application value of positron emission tomography/computed tomography (PET/CT) in early diagnosis of lung cancer. METHODS: Clinical studies evaluating the application value of PET/CT for patients underwent PET/CT imaging. The histological diagnosis served as the standard of truth. RESULTS: Four clinical studies which including 1330 patients with pulmonary space- occupying lesions were considered eligible for inclusion. Systemic analysis suggested that, in all 1330 patients, pooled sensitivity was 98.7% (1313.2/1330) and specificity was 58.2%(276.85/476). CONCLUSION: This systemic analysis suggests that integrated PET/CT imaging provides high sensitivity, and reasonably high specificity, and could be applied for early diagnosis of lung cancer.
Subject(s)
Early Detection of Cancer/methods , Lung Neoplasms/diagnosis , Multimodal Imaging/methods , Positron-Emission Tomography/methods , Tomography, X-Ray Computed/methods , Fluorodeoxyglucose F18/pharmacokinetics , Humans , Meta-Analysis as Topic , Neoplasm Staging , Prognosis , Radiopharmaceuticals/pharmacokinetics , Tissue DistributionABSTRACT
OBJECTIVE: To evaluate the performance of FDG dual-head tomography with coincidence (DHTC) imaging and serum tumor marker assays in identifying lung carcinoma in 160 patients with abnormal findings on chest radiography. METHODS: A prospective evaluation of FDG imaging with DHTC and the measurement of 3 serum tumor markers for lung cancer (carcinoembryonic antigen, CYFRA21-1 and neuron specific enolase) were performed in two weeks in 160 consecutive patients with known or suspected lung malignancy. All images were analyzed visually, and the count ratio of tumor to normal tissue (T/N ratio) was calculated. It was considered positive if the FDG uptake was increased relative to that in the adjacent lung tissue, and the uptake was focal and the T/N ratio > or = 1.3. The serum tumor marker test was considered positive for malignancy if the serum level of at least 1 marker was elevated. RESULTS: 127 patients were proven to have lung cancer by pathology, and 33 patients had benign lung disease. The sensitivity, specificity and accuracy of FDG DHTC in assessing lung cancer were 94.5%, 84.8% and 92.5%, respectively, and those of the serum tumor markers were 67.7%, 84.8% and 71.3%, respectively. FDG DHTC showed significantly higher sensitivity (P < 0.001) and accuracy (P < 0.001) than serum tumor markers. Four patients with lung cancer had negative findings on FDG DHTC but had positive serum markers. CONCLUSION: FDG DHTC imaging is a powerful tool for evaluating patients with lung lesions suggestive of malignancy. Although the determination of serum tumor marker levels is less accurate than FDG DHTC, the combination of a positive FDG result and positive tumor markers may be helpful in improving the diagnosis of lung cancer.
