Mid term outcome of non-small cell lung cancer at Dong Nai General Hospital

Abstract

Introduction: Multimodal treatment of non-small cell lung cancer at Dong Nai General Hospital needs to be evaluated. CEA and Cyfra21-1 are the most commonly used cancer markers in the clinical diagnosis of lung cancer. Determining the sensitivity and specificity of CEA and Cyfra21-1 in clinical practice as well as redetermining the optimal cut-off threshold of the test will help doctors in the department in diagnosing the disease.

Methods: Cross-sectional analysis. Cox regression was used to compare the risk of mortality in the perioperative period. ROC curve was plotted to calculate AUC and optimal cut-off was found using Youden index.

Results: There were 96 cases of confirmed lung cancer in the study, the average age was 62.7±9.7 years with a male:female ratio of 2:1. 36% of cases were hospitalized for chest pain, 22% were asymptomatic. In the study group, only 14% of patients were detected with early stage lung tumors, and only 56% agreed to be treated according to the hospital protocol. Participation in treatment according to the hospital protocol reduced the risk of death at the intermediate stage by 65% ​​in the group diagnosed with lung cancer or 64% in the group with late stage lung cancer when compared with the group refusing treatment with p and HR of 0.35 (p= 0.001) and 0.36 (p = 0,01), respectively. The actual sensitivity and specificity of CEA and Cyfra21-1 were (84.4% and 64.4%) and Cyfra (86.3% and 74.2%), respectively. The optimal cut-offs determined by the ROC curve of CEA and Cyfra21-1 were associated with sensitivity and specificity of (3.77ng/ml;84%;81%) and (2.99ng/ml;84%;84%), respectively.

Conclusion: Radical treatment will help reduce the midterm mortality with in non small cell lung cancer patients. Using CEA and Cyfra21-1 tests to diagnose cancer in a hospitalized patient with suspected lung lesions has a sensitivity and specificity of (84%; 81%) for CEA and (84%; 84%) for Cyfra21-1, respectively, with the recommended cutoffs being 3.77 ng/ml CEA and 2.99 ng/ml Cyfra21-1.