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Analysis of tumor markers in cytological fluid obtained from computed tomography–guided needle aspiration biopsies for the diagnosis of ground-glass opacity pulmonary lesions

Authors
 Ga Ram Kim  ;  Jin Hur  ;  Hye-Jeong Lee  ;  Ji Eun Nam  ;  Young Jin Kim  ;  Yoo Jin Hong  ;  Hyo Sup Shim  ;  Hee Yeong Kim  ;  Ji Won Lee  ;  Byoung Wook Choi 
Citation
 CANCER CYTOPATHOLOGY, Vol.121(4) : 214-222, 2013 
Journal Title
 CANCER CYTOPATHOLOGY 
ISSN
 1934-662X 
Issue Date
2013
MeSH
Adult ; Aged ; Antigens, Neoplasm/metabolism* ; Biomarkers, Tumor/metabolism* ; Biopsy, Needle ; Carcinoembryonic Antigen/metabolism ; Cytodiagnosis ; Female ; Humans ; Image-Guided Biopsy ; Keratin-19/metabolism* ; Lung/metabolism ; Lung/pathology* ; Lung Diseases/diagnosis* ; Lung Diseases/metabolism ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed*
Keywords
Adult ; Aged ; Antigens, Neoplasm/metabolism* ; Biomarkers, Tumor/metabolism* ; Biopsy, Needle ; Carcinoembryonic Antigen/metabolism ; Cytodiagnosis ; Female ; Humans ; Image-Guided Biopsy ; Keratin-19/metabolism* ; Lung/metabolism ; Lung/pathology* ; Lung Diseases/diagnosis* ; Lung Diseases/metabolism ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed*
Abstract
BACKGROUND: The purpose of this study was to assess whether analyses of tumor markers in cytological fluid can improve the performance of computed tomography (CT)-guided needle aspiration biopsy (NAB) for the diagnosis of ground-glass opacity (GGO) pulmonary lesions. METHODS: Forty-two patients were prospectively enrolled for CT-guided NAB. Levels of cytokeratin 19 fragments (CYFRA 21-1) and carcinoembryonic antigen (CEA) from serum and cytological fluid were measured. The cutoff values of 3.3 ng/mL for CYFRA 21-1 and 5.0 ng/mL for CEA (threshold A) or thresholds by adding 2 standard deviations to the mean levels of markers found in patients without malignancy (threshold B) were used to identify malignancy. The sensitivity and area under the curve (AUC) of NAB alone were compared with those of NAB combined with serum or cytological tumor markers. RESULTS: Among the 42 patients, 30 (71.4%) had malignant and 12 (28.6%) had benign lesions. For NAB alone, the sensitivity, specificity, and AUC for diagnosing GGO were 70.0%, 100%, and 0.850, respectively. The sensitivity and AUC increased significantly for NAB with cytological CYFRA 21-1 compared with NAB alone, using both thresholds (threshold A: 86.7%, P=.026 and .933, P=.016; threshold B: 93.3%, P=.008 and .925, P=.046). CONCLUSIONS: Cytological fluid measurements of CYFRA 21-1 can improve the diagnostic performance of CT-guided NAB for GGO pulmonary lesions.
Files in This Item:
T201301869.pdf Download
DOI
10.1002/cncy.21244
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ga Ram(김가람) ORCID logo https://orcid.org/0000-0002-4481-5792
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Hee Yeong(김희영)
Nam, Ji Eun(남지은)
Shim, Hyo Sup(심효섭) ORCID logo https://orcid.org/0000-0002-5718-3624
Lee, Ji Won(이지원)
Lee, Hye Jeong(이혜정) ORCID logo https://orcid.org/0000-0003-4349-9174
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Hur, Jin(허진) ORCID logo https://orcid.org/0000-0002-8651-6571
Hong, Yoo Jin(홍유진) ORCID logo https://orcid.org/0000-0002-7276-0944
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87075
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