NSCLC subtype prediction using cytologic fluid specimens from needle aspiration biopsies

Am J Clin Pathol. 2013 Mar;139(3):309-16. doi: 10.1309/AJCPYOJYG56UNBSZ.

Abstract

This study evaluated the diagnostic usefulness of tumor marker concentrations in cytologic fluids (CF) for subtyping non-small cell lung cancer (NSCLC) and assessed the relationship between fluorine-18-fluorodeoxyglucose ((18)F-FDG) uptake with serum and CF tumor marker levels. This prospective study included 88 patients diagnosed with adenocarcinoma or squamous cell carcinoma (SCC). Cytokeratin-19 fragment (CYFRA 21-1), carcinoembryonic antigen (CEA), and squamous cell carcinoma antigen (SCCA) concentrations in the CF samples were correlated with serum tumor marker concentrations, (18)F-FDG uptake, and NSCLC subtype. Fifty-eight patients were diagnosed with adenocarcinoma. Multivariate analysis revealed higher CF and serum SCCA levels; smoking status predicted SCC from adenocarcinoma. CF SCCA showed the highest accuracy (83%) in distinguishing between SCC and adenocarcinoma. CF samples obtained during routine needle aspiration biopsy procedure contain tumor marker levels sufficient to distinguish between SCC and adenocarcinoma; CF SCCA had the highest diagnostic accuracy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antigens, Neoplasm / analysis
  • Area Under Curve
  • Biomarkers, Tumor / analysis*
  • Biopsy, Needle
  • Body Fluids / chemistry*
  • Carcinoembryonic Antigen / analysis
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Cytodiagnosis
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Keratin-19 / analysis
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / surgery
  • Male
  • Positron-Emission Tomography
  • ROC Curve
  • Radiopharmaceuticals
  • Sensitivity and Specificity

Substances

  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Keratin-19
  • Radiopharmaceuticals
  • antigen CYFRA21.1
  • Fluorodeoxyglucose F18