Introduction. Preoperative detection of pleural invasion in lung cancer patients is key to curative surgical treatment. We tried to predict pleural invasion in non-small-cell lung cancer patients with <100 ml pleural fluid. Methods. Patients admitted from August 1, 2011, to December 31, 2018, were retrospectively retrieved. Records of serum and imaging markers were analyzed. Results. Among 7004 patients who received surgery, 43 cases with <100 ml pleural fluid who had pleural invasion were included, and another 108 cases without pleural invasion were enrolled as controls. There were no differences in squamous cell carcinoma antigen (SCC) or neuron-specific enolase (NSE) values between the pleural invasion and noninvasion groups ( and 0.14, respectively), but there were significant differences in carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA21-1) values ( and 0.01, respectively). There were significant differences in the location of original lung cancer (right mid lobe, ), maximum lung lesion diameter (), volume of pleural fluid (nondetectable vs. detectable fluid, ), pleural sign (), and positron emission tomography/computed tomography- (PET/CT-) predicted pleural invasion () between the pleural invasion and noninvasion groups. The maximum Area-Under-the-Curve in the Receiver Operating Characteristic curve analysis was achieved with the combination of CEA, CYFRA21-1, detectable pleural fluid, PET/CT prediction, pleural sign, and location of the lung lesion. Conclusions. Serum CEA and CYFRA21-1, location of original lung cancer (right mid lobe), maximum diameter, CT-detectable pleural fluid, pleural sign by CT, and PET/CT-predicted pleural invasion were good markers for the prediction of pleural invasion in non-small-cell lung cancer patients.

中文翻译：

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使用血清和影像标志物预测具有挑战性的非小细胞肺癌患者的胸膜浸润。

简介。肺癌患者胸膜浸润的术前检测是根治性手术治疗的关键。我们试图预测胸水 <100 ml 的非小细胞肺癌患者的胸膜浸润。方法。回顾性检索2011年8月1日至2018年12月31日入院的患者。分析了血清和成像标志物的记录。结果。7004例接受手术的患者中，43例胸水<100 ml有胸膜侵犯者，另108例无胸膜侵犯者作为对照。胸膜浸润组和非浸润组的鳞状细胞癌抗原（SCC）或神经元特异性烯醇化酶（NSE）值没有差异。和 0.14），但癌胚抗原（CEA）和细胞角蛋白 19 片段（CYFRA21-1）值有显着差异（和 0.01，分别）。原发肺癌部位（右中叶、),最大肺部病变直径 ()，胸腔积液量（检测不到与可检测到的液体，),胸膜征 (），正电子发射断层扫描/计算机断层扫描（PET/CT-）预测胸膜浸润（)在胸膜浸润组和非浸润组之间。CEA、CYFRA21-1、可检测胸水、PET/CT 预测、胸膜征和肺部病变位置的组合实现了接受者操作特征曲线分析中的最大曲线下面积。结论。血清 CEA 和 CYFRA21-1、原发肺癌的位置（右肺中叶）、最大直径、CT 可检测的胸水、CT 的胸膜征和 PET/CT 预测的胸膜浸润是预测肺癌胸膜浸润的良好标志物非小细胞肺癌患者。