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Combined tumor markers and CT imaging show high sensitivity for solitary pulmonary nodule malignancy

Combined tumor markers and CT imaging show high sensitivity for solitary pulmonary nodule malignancy
Photo by FÍA YANG / Unsplash
Key Takeaway
Consider combined tumor markers and CT findings for SPN assessment, but recognize retrospective evidence limitations.

A retrospective cohort study evaluated 110 patients with solitary pulmonary nodules (45 benign, 65 malignant) to assess the diagnostic efficacy of combining serum tumor markers (CEA, NSE, CA-125, CYFRA 21-1) with high-resolution CT imaging for malignancy risk assessment. The comparator was benign solitary pulmonary nodules.

Serum levels of CEA, CA-125, CYFRA 21-1, and NSE were significantly higher in the malignant nodule group (P < 0.001). CT imaging findings in malignant nodules typically exhibited deep lobulation, pleural indentation, short fine spiculation, and multiple cystic lucencies, while benign nodules more commonly displayed pleural thickening and satellite lesions.

The combined detection of CT imaging and tumor markers showed significantly superior diagnostic efficacy compared to single tests, with an area under the curve significantly higher than any single indicator. The combined approach achieved sensitivity of 96.9% and accuracy of 87.3% (P < 0.05). Safety and tolerability data were not reported.

Key limitations include the retrospective design, which prevents causal inference. The study population was limited to 110 patients, and findings cannot be generalized beyond this cohort without prospective validation. While the combined detection approach shows promise for offering a more precise basis for cancer risk assessment, its clinical utility remains uncertain without prospective studies.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
IntroductionThis study aims to investigate the correlation between serum tumor markers (CEA, NSE, CA-125, and CYFRA 21-1) and imaging findings in patients with solitary pulmonary nodules, and to assess their value in predicting the risk of malignancy.MethodsA retrospective analysis was conducted on 110 patients with solitary pulmonary nodules, of whom 45 were benign and 65 were malignant. The clinical data, serum tumor marker levels, CT imaging findings, and diagnostic efficacy of single and combined tests were compared between the two groups.ResultsSerum levels of CEA, CA-125, CYFRA 21-1, and NSE in the malignant nodule group were significantly higher than those in the benign nodule group (P < 0.001). CT imaging revealed that patients with malignant nodules typically exhibited characteristics such as deep lobulation, pleural indentation, short fine spiculation, and multiple cystic lucencies, whereas the benign nodule group more commonly displayed pleural thickening and satellite lesions. The diagnostic efficacy of combined CT and tumor marker testing was significantly superior to that of single tests, with a sensitivity of 96.9% and an accuracy of 87.3%. The area under the curve (AUC) of the combined detection was significantly higher than that of any single indicator (P < 0.05).DiscussionThe combined detection of serum tumor markers and high-resolution CT imaging findings has high clinical value in the diagnosis of benign and malignant solitary pulmonary nodules, offering a more precise basis for cancer risk assessment.
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