Early Lung Cancer Detection Using Spiral Computed Tomography and Positron Emission Tomography

Bastarrika, Gorka; García-Velloso, María José; Lozano, Marı́a D.; Montes, Usua; Torre, W.; Spiteri, Natalia; Campo, Arantza; Seijó, Luis; Alcaide, Ana B.; Pueyo, Jesús C.; Cano, David; Vivas, Isabel; Cosín, O.; Domínguez, Pablo; Serra, Patrícia; Richter, José A.; Montuenga, Luis M.; Zulueta, Javier J.

doi:10.1164/rccm.200411-1479oc

Cited by 152 publications

(103 citation statements)

References 34 publications

(44 reference statements)

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“…2 Recently, low-dose spiral computed tomography (CT) has been proposed as an early detection screening tool. However, despite its high sensitivity, specificity of CT in lung cancer detection is poor.…”

Section: Uiccmentioning

confidence: 99%

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WT1 IgG antibody for early detection of nonsmall cell lung cancer and as its prognostic factor

Oji

Kitamura

Kamino

et al. 2009

Intl Journal of Cancer

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There are urgent needs to develop methods for early detection of nonsmall cell lung cancer (NSCLC) because of its increasing incidence and poor prognosis. Here, we analyzed the production of IgG antibody (WT1 Ab) against WT1 (Wilms' tumor gene) protein that was overexpressed in the majority of NSCLC. Enzymelinked immuno-sorbent assay showed that WT1 Ab was produced in all of 91 NSCLC patients and 70 healthy individuals and that WT1 Ab titers were significantly higher in NSCLC patients compared with healthy individuals. When the cut-off level of WT1 Ab titers were fixed at mean 1 3SD of those in healthy individuals, 26.4% of NSCLC patients had WT1 Ab titers over the cut-off level, and positive rates of WT1 Ab at each clinical stage were 25.0, 30.8 and 38.4% in stage I, II and III NSCLC, respectively. When WT1 Ab was combined with CEA or CYFRA for detection of NSCLC, positive detection rates increased from 25.0 to 34.1 and 31.8%, respectively, in stage I and from 38.4 to 69.2 and 46.1%, respectively, in stage III, but not changed in stage II. Western blot analysis showed that dominant subclass of WT1 Ab was Th1-type IgG2. Interestingly, elevation of WT1 Ab titers was significantly associated with longer disease-free survival in patients with stages I-III NSCLC. These results showed that WT1 Ab could be a useful marker for early detection of NSCLC and its prognostic prediction. These results also suggested that WT1-specific immune responses played an important role in anti-cancer immunity in NSCLC. ' UICCKey words: lung cancer; WT1; humoral immune response; tumor marker; prognostic marker Lung cancer is the leading cause of cancer death in the world and nonsmall cell lung cancer (NSCLC) represents nearly 80% of the disease. 1 Because 75% of lung cancer patients are diagnosed at stages of metastatic spread when therapies are rarely curative, 2 early detection of localized lung cancer is the key to improve its clinical outcome.Although chest X-ray is routinely used as a screening tool, its limitation to detect localized lung cancer has been evident because of its insufficient sensitivity. 2 Recently, low-dose spiral computed tomography (CT) has been proposed as an early detection screening tool. However, despite its high sensitivity, specificity of CT in lung cancer detection is poor. 3 Therefore, serum biomarkers with high sensitivity and specificity for diagnosis of lung cancer are needed. However, current serum biomarkers for NSCLC such as carcino embryonic antigens (CEA) and squamous cell carcinoma antigen do not have sufficient sensitivity and specificity required for early detection of NSCLC. 4,5 It is now clear that malignant transformation occurs by changes in cellular gene expression with subsequent clonal proliferation. Altered gene expression in malignant cells may lead to the expression of aberrantly expressed proteins recognized by host immune system. If autoantibodies against these antigens are produced at early stage of NSCLC when quantity of the tumor antigens in the circulation is very small, these...

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Section: Uiccmentioning

confidence: 99%

“…1 Because 75% of lung cancer patients are diagnosed at stages of metastatic spread when therapies are rarely curative, 2 early detection of localized lung cancer is the key to improve its clinical outcome.…”

Section: Uiccmentioning

confidence: 99%

WT1 IgG antibody for early detection of nonsmall cell lung cancer and as its prognostic factor

Oji

Kitamura

Kamino

et al. 2009

Intl Journal of Cancer

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“…Multidetector computed tomography (MDCT) (1)(2)(3)(4) and fluorodeoxyglucose-positron emission tomography (FDG-PET) (5,6) are used to detect and diagnose pulmonary lesions. Early detection improves prognosis, but the pulmonary lesion detection rates are approximately 20% (1-4) and <3% (5,6) for these two methods, respectively.…”

Section: Introductionmentioning

confidence: 99%

Computed tomography‑guided lung biopsy: Association between biopsy needle angle and pneumothorax development

et al. 2017

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Abstract. Computed tomography (CT)-guided lung biopsy is a well-established diagnostic method for pulmonary lesions. However, the use of this technique often results in pneumothorax development. The aim of the present study was to evaluate the association between biopsy needle angle and pneumothorax development associated with computed tomography-guided lung biopsy. We retrospectively analyzed the results of CT-guided lung biopsies for 325 cases to investigate physical risk factors for pneumothorax development. Biopsy needle angle and patient positioning were included in the analysis. Pneumothorax occurred in 160 of 325 procedures (49.2%). Discontinuation of the procedure as a result of pneumothorax occurred in 18 of 160 procedures (11.2%). Upper lung lobe pneumothorax occurred in 40.8% (58/142), middle lobe in 17.6% (25/142), and lower lobe pneumothorax occurred in 41.5% (59/142) of these procedures. Discontinuation of the procedure occurred in 2.5% of the upper lobe (4/160), 0.6% of the middle lobe (1/160), and 8.1% of the lower lobe (13/160) biopsies. Mild pneumothorax occurred in 59.4% (95/160), moderate in 25.0% (40/160), and severe in 7.5% (12/160) of the affected cases, and biopsy was discontinued in 11.2% (18/160) of the affected cases. When the needle angle was <90˚, 40.3% (131/325) of the patients experienced no pneumothorax development, 40.0% (130/325) developed pneumothorax, and 4.3% (14/325) of the procedures were discontinued. The results showed that use of CT-guided lung biopsy can reduce the rate of pneumothorax development that occurs when other procedures are used. The access route is simple and easy to puncture, and proper use of breath holding reduces diaphragmatic movement.

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“…The frequency of further CT imaging among screened individuals has ranged from 1% in the study by Veronesi et al [30] to 44.6% in the study by Sobue et al [31]. The frequency of further positron emission tomography (PET) imaging among screened individuals has exhibited less variation, ranging from 2.5% in the study by Bastarrika et al [32] to 5.5% in the NLST.…”

Section: Downsides Of Ldct Screeningmentioning

confidence: 99%

Low-Dose Computed Tomography Screening for Lung Cancer

Rogers¹

2017

A Global Scientific Vision - Prevention, Diagnosis, and Treatment of Lung Cancer

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In the landmark American National Lung Cancer Screening Trial (NLST), low-dose CT (LDCT) screening produced a relative mortality reduction of 20%. These results have not been replicated in any of the European studies, although these are of limited statistical power. Besides doubt about the general applicability of the NLST findings, if LDCT screening is to be successfully implemented, a number of developments are still required, including better characterisation of entry criteria and refinement of screening and nodule management protocols. The high incidence of false-positive findings increases costs and morbidity. Even when histologically malignant tumours are identified, frequently these would not have manifested as disease, i.e. they are "overdiagnosed". These patients are liable to receive unnecessary treatment. LDCT screening is relatively expensive in comparison with other cancer screening modalities. Whilst cost-effectiveness can be improved by integration with smoking cessation programmes, how this would be done in practice remains unclear. Furthermore, individuals at high-risk of lung cancer are virtually by definition risk prone, raising concerns about how attractive participation in a screening programme would be, especially given the very small reported absolute risk reduction in the NLST.

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Early Lung Cancer Detection Using Spiral Computed Tomography and Positron Emission Tomography

Cited by 152 publications

References 34 publications

WT1 IgG antibody for early detection of nonsmall cell lung cancer and as its prognostic factor

WT1 IgG antibody for early detection of nonsmall cell lung cancer and as its prognostic factor

Computed tomography‑guided lung biopsy: Association between biopsy needle angle and pneumothorax development

Low-Dose Computed Tomography Screening for Lung Cancer

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