Diagnostic Characteristics of a Serum Biomarker in Patients With Positron Emission Tomography Scans

Eric L. Grogan, Stephen Deppen, Chad V. Pecot, Joe B. Putnam, Jonathan C. Nesbitt, Yu Shyr, Rama Rajanbabu, Bridget Ory, Eric S. Lambright, Pierre P. Massion

研究成果: Article同行評審

3 引文 斯高帕斯(Scopus)

摘要

Background: Surgery for pulmonary nodules results in a benign diagnosis in 10% to 30% of cases. Computed tomography and fluorodeoxyglucose-positron emission tomography (FDG-PET) are highly sensitive but less specific. High-risk patients (age > 55 years and smoke > 15 pack-years) for lung cancer with negative FDG-PET scans, or low-risk patients (age < 55 years or smoke < 15 pack-years) with FDG-PET-avid lesions may have higher rates of benign nodules. We hypothesized that our serum biomarker improves diagnostic accuracy by providing greater specificity. Methods: Fifty-eight patients with pulmonary nodules (≤3 cm) were prospectively enrolled. We tested the accuracy of our proteomic biomarker in the serum by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Malignancy rates, contingency tables, sensitivity, and specificity analyses were calculated for the entire group and in a subset of patients at high risk for benign disease. Results: We identified 46 (79%) lung cancers and 12 (21%) benign lesions. Forty-five nodules were FDG-PET-avid. In 36 high-risk patients with FDG-PET-avid lesions, 32 (89%) had cancer. Of the remaining 22 lower-risk patients, 14 (64%) had cancer (p = 0.02). The serum biomarker sensitivity was 26.1%, specificity was 91.7%, positive predictive value was 92%, negative predictive value was 24%, and overall accuracy was 40%. The serum signature accurately predicted all eight benign nodules in this 22-patient subset. Conclusions: The serum protein biomarker has a high specificity. This biomarker has a high positive predictive value but low negative predictive value and may improve noninvasive evaluation of lung nodules. Validation in a larger population is warranted.

原文English
頁(從 - 到)1724-1729
頁數6
期刊Annals of Thoracic Surgery
89
發行號6
DOIs
出版狀態Published - 2010 六月

All Science Journal Classification (ASJC) codes

  • 手術
  • 肺和呼吸系統醫學
  • 心臟病學與心血管醫學

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