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