The Investigation Of The Correlation Between 18F-FDG SPECT/CT And CT Signs And Serum Tumor Markers Levels In Patients With Primary Lung Cancer

Objective:To investigate the correlation between 18F-FDG SPECT/CT metabolic imaging and CT signs and serum tumor markers levels in patients with primary lung cancer.Methods:From January 2014 to December 2016,we involved 43patients with confirmed primary lung cancer,who had underwent whole-body18F-FDG SPECT/CT scan in our hospital and did not receive any treatment.These patients’imaging signs,serum tumor markers levels（CEA,SCC,NSE,CYFRA21-1,ProGRP,TPA）and other clinical data were studied respectively.18F-FDG SPECT/CT,chest CT examination,and serum tumor markers were performanced within an interval of half a month.SPSS13.0 statistic software was used for statistical analyses.The±sd was used for descriptive statistical data.T test was used in the comparison of different manifestations between the two groups.Variance analysis or nonparametric test was used for the multiple comparisons.Pearson or Spearman was used for univariate correlation analysis.The results were statistically different when p<0.05.The diagnosis of lung cancer was based on the pathology or cytological examination,medical imaging,and clinical follow-up.The follow-up time was longer than 3months.Results:1.Lobulation and spiculation were common signs in chest CT imaging.In 43 patients,9 patients（20.93%）were positive for both lobulation and spiculation,16 patients（64.00%）were positive for lobulation but negative for spiculation,8 patients（18.60%）were positive for spiculation but negative for lobulation,and 10 patients（23.26%）were negative for both lobulation and spiculation.2.The T/B values for above four groups of patients were 9.87±6.56,5.56±2.28,4.18±2.19 and 5.16±4.38,respectively.The T/B value was significantly different between the patients with both positive lobulation and spiculation and the patients with positive spiculation but negative lobulation,and the patients with both negative lobulation and spiculation（p<0.05）.The result of univariate correlation analysis showed that lobulation sign was positive correlation with the T/B value of the primary lung cancer(r_s=0.374,p=0.013,<0.05).3.The values of serum tumor markers for some patients were not available,so less than 43 patients were evaluated.The positive rate for serum CYFRA21-1,TPA,CEA,NSE,proGRP and SCC were 84.85%（28/33）,75%（24/35）,55.60%（20/35）,42.90%（15/35）,19.40%（6/33）and 6.06%（2/33）,respectively.There is no difference of T/B values between any group of patients with normal and elevated tumor markers（p>0.05）.Then we selected three tumor markers（CYFRA21-1,TPA and CEA）with the higher positive rates and grouped the patients as positive and negative according to the level of each tumor marker.There were three positive groups:（1）only one tumor marker level elevated（5 patients,T/B=6.98±5.84）;（2）only two tumor markers level elevated（11 patients,T/B=5.00±3.09）;（3）three tumor markers level elevated（12 patients,T/B=7.48±5.99）.The negative group means three tumor markers were at normal level,including 2 patients,with its T/B=8.60±5.80.There were no significant differences of T/B values between these four groups of patients.There is no association between the T/B values and serum levels of these tumor markers with univariate correlation analysis.4.The maximum diameter of primary lung cancer lesions was less than3cm in 24/43 patients and was more than 3cm in 19/43 patients.The T/B values for the two groups of patients were 4.38±1.70 and 8.30±5.60,respectively,which is significantly different（t=-2.936,p=0.008）.There is a positive correlation between the maximum diameter of primary lung cancer lesions and the T/B values（r=0.599,p=0.00<0.05）.However,the T/B value is not significantly different in other clinical variables（age,gender,and histological type）,neither is the correlation between T/B values and these variables.Conclusions:1.The common signs of primary lung cancer in chest CT imaging are lobulation and spiculation.However,the positive rate is not high.2.Lobulation but not spiculation was positively correlated with T/B values of primary lung cancer.3.In preoperative patients with lung cancer,CYFRA21-1,TPA and CEA had the higher positive rates.The T/B values were not different between the positive and negative groups of these three tumor markers,nor were the association between the serum levels of tumor markers and the T/B values of the primary lung cancer.4.The maximum diameters of primary lung cancer lesions were positively correlated with the T/B values;however age,gender and histological type were not associated with T/B values.