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      The relationship between tumor markers and pulmonary embolism in lung cancer

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          Abstract

          Background

          Tumor markers (TMs) and D-Dimer are both hallmarks of severity and prognosis of lung cancer. Tumor markers could be related to pulmonary embolism (PE) in lung cancer.

          Results

          The number of abnormal tumor markers of lung cancer patients with pulmonary embolism (3.9 ± 1.1vs1.6 ± 0.6,P 0.005) was more than that in patients without pulmonary embolism. TMs panel (P trend < 0.001), CEA (R2 0.735, P0.003) and CYFRA21-1 (R2 0.718, P0.005) were positively correlated with D-Dimer in patients with pulmonary embolism. The multivariate logistic regression analysis showed that, for tumor markers, TMs panel (OR5.98, P < 0.001) had the strongest correlation with pulmonary embolism. The AUC (area under curve) of TMs panel and CEA were 0.82 [95%CI (0.71–0.95), P < 0.001] and 0.71 [95%CI (0.62–0.84), P 0.002] by ROC (receiver operating characteristic) curve analysis, respectively.

          Materials and Methods

          Tumor markers were compared between lung cancer patients complicated with pulmonary embolism and those without pulmonary embolism Then the correlation between each tumor marker as well as panel of combined TMs and D-Dimer as well as pulmonary embolism were analyzed for patients with pulmonary embolism.

          Conclusions

          There is a relationship between tumor markers and pulmonary embolism in patients with lung cancer. The panel of combined tumor markers is a valuable diagnostic marker for pulmonary embolism in lung cancer.

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          Most cited references26

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          2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism.

          Stavros V Konstantinides, Adam Torbicki, Giancarlo Agnelli … (2014)
          Article 0 comments Cited 693 times – based on 0 reviews     Review now
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            The revised TNM staging system for lung cancer.

            Thomas Crowley, Ramón Rami-Porta, P Goldstraw (2009)
            The International Staging Committee (ISC) of the International Association for the Study of Lung Cancer (IASLC) collected 68,463 patients with nonsmall cell lung cancer and 13,032 patients with small cell lung cancer, registered or diagnosed from 1990 to 2000, whose records had adequate information for analyzing the tumor, node, metastasis (TNM) classification. The T, N, and M descriptors were analyzed, and recommendations for changes in the seventh edition of the TNM classification were proposed based on differences in survival. For the T component, tumor size was found to have prognostic relevance, and its analysis led to recommendations to subclassify T1 tumors into T1a ( 2 - 3 - 5 - 7 cm into T3. Furthermore, with additional nodules in the same lobe as the primary tumors, T4 tumors would be reclassified as T3; with additional nodules in another ipsilateral lobe, M1 as T4; and with pleural dissemination, T4 as M1. There were no changes in the N category. In the M category, M1 was recommended to be subclassified into M1a (contralateral lung nodules and pleural dissemination) and M1b (distant metastasis). The proposed changes for the new stage grouping were to upstage T2bN0M0 from stage IB to stage IIA, and to downstage T2aN1M0 from stage IIB to stage IIA and T4N0-N1M0 from stage IIIB to stage IIIA. The proposed changes better differentiate tumors of different prognoses.
            Article 0 comments Cited 86 times – based on 0 reviews     Review now
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              Biomarkers for prediction of venous thromboembolism in cancer.

              Ingrid Pabinger, Johannes Thaler, Cihan Ay (2013)
              Cancer patients are at increased risk of deep vein thrombosis and pulmonary embolism. The incidence among different groups of cancer patients varies considerably depending on clinical factors, the most important being tumor entity and stage. Biomarkers have been specifically investigated for their capacity of predicting venous thromboembolism (VTE) during the course of disease. Parameters of blood count analysis (elevated leukocyte and platelet count and decreased hemoglobin) have turned out to be useful in risk prediction. Associations between elevated levels and future VTE have been found for d-dimer, prothrombin fragment 1+2, and soluble P-selectin and also for clotting factor VIII and the thrombin generation potential. The results for tissue factor-bearing microparticles are heterogeneous: an association with occurrence of VTE in pancreatic cancer might be present, whereas in other cancer entities, such as glioblastoma, colorectal, or gastric carcinoma, this could not be confirmed. Risk assessment models were developed that include clinical and laboratory markers. In the high-risk categories, patient groups with up to a >20% VTE rate within 6 months can be identified. A further improvement in risk stratification would allow better identification of patients for primary VTE prevention using indirect or novel direct anticoagulants.
              Article 0 comments Cited 77 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Oncotarget
                Journal ID (iso-abbrev): Oncotarget
                Journal ID (publisher-id): Oncotarget
                Journal ID (publisher-id): ImpactJ
                Title: Oncotarget
                Publisher: Impact Journals LLC
                ISSN (Electronic): 1949-2553
                Publication date Collection: 20 June 2017
                Publication date (Electronic): 17 May 2017
                Volume: 8
                Issue: 25
                Pages: 41412-41421
                Affiliations
                1 Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
                2 Department of Respiratory Medicine, Punan Hospital, Pudong New District, Shanghai, China
                3 Department of Respiratory Medicine, Gongli Hospital, Pudong New District, Second Military Medical University, Shanghai, China
                4 Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
                5 Department of Respiratory Medicine, Renji Hospital, Jiaotong University School of Medicine, Shanghai, China
                Author notes
                Correspondence to: Jinming Liu, jinmingliu2013@ 123456126.com
                Article
                Publisher ID: 17916
                DOI: 10.18632/oncotarget.17916
                PMC ID: 5522295
                PubMed ID: 28575869
                SO-VID: b45ec405-ef84-49cb-92ff-50185712b02a
                Copyright © Copyright: © 2017 Xiong et al.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License 3.0 (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 6 March 2017
                Date accepted : 1 May 2017
                Categories
                Subject: Research Paper

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: tumor markers,pulmonary embolism,lung cancer,panel of combined tumor markers,cea
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: tumor markers, pulmonary embolism, lung cancer, panel of combined tumor markers, cea

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