1
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Bisanzi S, Puliti D, Picozzi G, Romei C, Pistelli F, Deliperi A, Carreras G, Masala G, Gorini G, Zappa M, Sani C, Carrozzi L, Paci E, Kaaks R, Carozzi FM, Mascalchi M. Baseline Cell-Free DNA Can Predict Malignancy of Nodules Observed in the ITALUNG Screening Trial. Cancers (Basel) 2024; 16:2276. [PMID: 38927981 PMCID: PMC11201711 DOI: 10.3390/cancers16122276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/08/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
The role of total plasma cell-free DNA (cfDNA) in lung cancer (LC) screening with low-dose computed tomography (LDCT) is uncertain. We hypothesized that cfDNA could support differentiation between malignant and benign nodules observed in LDCT. The baseline cfDNA was measured in 137 subjects of the ITALUNG trial, including 29 subjects with screen-detected LC (17 prevalent and 12 incident) and 108 subjects with benign nodules. The predictive capability of baseline cfDNA to differentiate malignant and benign nodules was compared to that of Lung-RADS classification and Brock score at initial LDCT (iLDCT). Subjects with prevalent LC showed both well-discriminating radiological characteristics of the malignant nodule (16 of 17 were classified as Lung-RADS 4) and markedly increased cfDNA (mean 18.8 ng/mL). The mean diameters and Brock scores of malignant nodules at iLDCT in subjects who were diagnosed with incident LC were not different from those of benign nodules. However, 75% (9/12) of subjects with incident LC showed a baseline cfDNA ≥ 3.15 ng/mL, compared to 34% (37/108) of subjects with benign nodules (p = 0.006). Moreover, baseline cfDNA was correlated (p = 0.001) with tumor growth, measured with volume doubling time. In conclusion, increased baseline cfDNA may help to differentiate subjects with malignant and benign nodules at LDCT.
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Affiliation(s)
- Simonetta Bisanzi
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (S.B.); (G.P.); (G.C.); (G.M.); (G.G.); (M.Z.); (C.S.); (E.P.); (F.M.C.)
| | - Donella Puliti
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (S.B.); (G.P.); (G.C.); (G.M.); (G.G.); (M.Z.); (C.S.); (E.P.); (F.M.C.)
| | - Giulia Picozzi
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (S.B.); (G.P.); (G.C.); (G.M.); (G.G.); (M.Z.); (C.S.); (E.P.); (F.M.C.)
| | - Chiara Romei
- Division of Radiology, Cisanello Hospital, Azienda Ospedaliera Pisana, 56124 Pisa, Italy; (C.R.); (A.D.)
| | - Francesco Pistelli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy, (L.C.)
- Pulmonary Unit, Cardiothoracic and Vascular Department, Pisa University Hospital, 56124 Pisa, Italy
| | - Annalisa Deliperi
- Division of Radiology, Cisanello Hospital, Azienda Ospedaliera Pisana, 56124 Pisa, Italy; (C.R.); (A.D.)
| | - Giulia Carreras
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (S.B.); (G.P.); (G.C.); (G.M.); (G.G.); (M.Z.); (C.S.); (E.P.); (F.M.C.)
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (S.B.); (G.P.); (G.C.); (G.M.); (G.G.); (M.Z.); (C.S.); (E.P.); (F.M.C.)
| | - Giuseppe Gorini
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (S.B.); (G.P.); (G.C.); (G.M.); (G.G.); (M.Z.); (C.S.); (E.P.); (F.M.C.)
| | - Marco Zappa
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (S.B.); (G.P.); (G.C.); (G.M.); (G.G.); (M.Z.); (C.S.); (E.P.); (F.M.C.)
| | - Cristina Sani
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (S.B.); (G.P.); (G.C.); (G.M.); (G.G.); (M.Z.); (C.S.); (E.P.); (F.M.C.)
| | - Laura Carrozzi
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy, (L.C.)
- Pulmonary Unit, Cardiothoracic and Vascular Department, Pisa University Hospital, 56124 Pisa, Italy
| | - Eugenio Paci
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (S.B.); (G.P.); (G.C.); (G.M.); (G.G.); (M.Z.); (C.S.); (E.P.); (F.M.C.)
| | - Rudolf Kaaks
- Division of Cancer Epidemiology (C020), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; (R.K.); (M.M.)
- Translational Lung Research Center Heidelberg (TLRC-H), German Center for Lung Research (DZL), 69120 Heidelberg, Germany
| | - Francesca Maria Carozzi
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Florence, Italy; (S.B.); (G.P.); (G.C.); (G.M.); (G.G.); (M.Z.); (C.S.); (E.P.); (F.M.C.)
| | - Mario Mascalchi
- Division of Cancer Epidemiology (C020), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; (R.K.); (M.M.)
- Department of Clinical and Experimental Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy
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2
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Mascalchi M, Picozzi G, Puliti D, Diciotti S, Deliperi A, Romei C, Falaschi F, Pistelli F, Grazzini M, Vannucchi L, Bisanzi S, Zappa M, Gorini G, Carozzi FM, Carrozzi L, Paci E. Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed. Diagnostics (Basel) 2023; 13:2197. [PMID: 37443590 DOI: 10.3390/diagnostics13132197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/15/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
The ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55-69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular mortality in the screened subjects after 13 years of follow-up, especially in women, and produced many ancillary studies. They included recruitment results of a population-based mimicking approach, development of software for computer-aided diagnosis (CAD) and lung nodules volumetry, LDCT assessment of pulmonary emphysema and coronary artery calcifications (CAC) and their relevance to long-term mortality, results of a smoking-cessation intervention, assessment of the radiations dose associated with screening LDCT, and the results of biomarkers assays. Moreover, ITALUNG data indicated that screen-detected LCs are mostly already present at baseline LDCT, can present as lung cancer associated with cystic airspaces, and can be multiple. However, several issues of LC screening are still unaddressed. They include the annual vs. biennial pace of LDCT, choice between opportunistic or population-based recruitment. and between uni or multi-centre screening, implementation of CAD-assisted reading, containment of false positive and negative LDCT results, incorporation of emphysema. and CAC quantification in models of personalized LC and mortality risk, validation of ultra-LDCT acquisitions, optimization of the smoking-cessation intervention. and prospective validation of the biomarkers.
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Affiliation(s)
- Mario Mascalchi
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, 50121 Florence, Italy
- Division of Epidemiology and Clinical Governance, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, Italy
| | - Giulia Picozzi
- Division of Epidemiology and Clinical Governance, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, Italy
| | - Donella Puliti
- Division of Epidemiology and Clinical Governance, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, Italy
| | - Stefano Diciotti
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, 47521 Cesena, Italy
| | - Annalisa Deliperi
- Radiodiagnostic Unit 2, Department of Diagnostic Imaging, Cisanello University Hospital of Pisa, 56124 Pisa, Italy
| | - Chiara Romei
- Radiodiagnostic Unit 2, Department of Diagnostic Imaging, Cisanello University Hospital of Pisa, 56124 Pisa, Italy
| | - Fabio Falaschi
- Radiodiagnostic Unit 2, Department of Diagnostic Imaging, Cisanello University Hospital of Pisa, 56124 Pisa, Italy
| | - Francesco Pistelli
- Pulmonary Unit, Cardiothoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy
| | - Michela Grazzini
- Division of Pneumonology, San Jacopo Hospital Pistoia, 51100 Pistoia, Italy
| | - Letizia Vannucchi
- Division of Radiology, San Jacopo Hospital Pistoia, 51100 Pistoia, Italy
| | - Simonetta Bisanzi
- Regional Laboratory of Cancer Prevention, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, Italy
| | - Marco Zappa
- Division of Epidemiology and Clinical Governance, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, Italy
| | - Giuseppe Gorini
- Division of Epidemiology and Clinical Governance, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, Italy
| | - Francesca Maria Carozzi
- Regional Laboratory of Cancer Prevention, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, Italy
| | - Laura Carrozzi
- Pulmonary Unit, Cardiothoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy
| | - Eugenio Paci
- Division of Epidemiology and Clinical Governance, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50100 Florence, Italy
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Lebrett MB, Crosbie EJ, Smith MJ, Woodward ER, Evans DG, Crosbie PAJ. Targeting lung cancer screening to individuals at greatest risk: the role of genetic factors. J Med Genet 2021; 58:217-226. [PMID: 33514608 PMCID: PMC8005792 DOI: 10.1136/jmedgenet-2020-107399] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/06/2020] [Accepted: 12/08/2020] [Indexed: 12/24/2022]
Abstract
Lung cancer (LC) is the most common global cancer. An individual’s risk of developing LC is mediated by an array of factors, including family history of the disease. Considerable research into genetic risk factors for LC has taken place in recent years, with both low-penetrance and high-penetrance variants implicated in increasing or decreasing a person’s risk of the disease. LC is the leading cause of cancer death worldwide; poor survival is driven by late onset of non-specific symptoms, resulting in late-stage diagnoses. Evidence for the efficacy of screening in detecting cancer earlier, thereby reducing lung-cancer specific mortality, is now well established. To ensure the cost-effectiveness of a screening programme and to limit the potential harms to participants, a risk threshold for screening eligibility is required. Risk prediction models (RPMs), which provide an individual’s personal risk of LC over a particular period based on a large number of risk factors, may improve the selection of high-risk individuals for LC screening when compared with generalised eligibility criteria that only consider smoking history and age. No currently used RPM integrates genetic risk factors into its calculation of risk. This review provides an overview of the evidence for LC screening, screening related harms and the use of RPMs in screening cohort selection. It gives a synopsis of the known genetic risk factors for lung cancer and discusses the evidence for including them in RPMs, focusing in particular on the use of polygenic risk scores to increase the accuracy of targeted lung cancer screening.
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Affiliation(s)
- Mikey B Lebrett
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK.,Prevention and Early Detection Theme, NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - Emma J Crosbie
- Prevention and Early Detection Theme, NIHR Manchester Biomedical Research Centre, Manchester, UK.,Division of Cancer Sciences, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK
| | - Miriam J Smith
- Prevention and Early Detection Theme, NIHR Manchester Biomedical Research Centre, Manchester, UK.,Manchester Centre for Genomic Medicine, St Mary's Hospital, Division of Evolution and Genomic Sciences, School of Biological Sciences, University of Manchester, Manchester, UK
| | - Emma R Woodward
- Prevention and Early Detection Theme, NIHR Manchester Biomedical Research Centre, Manchester, UK.,Manchester Centre for Genomic Medicine, St Mary's Hospital, Division of Evolution and Genomic Sciences, School of Biological Sciences, University of Manchester, Manchester, UK
| | - D Gareth Evans
- Prevention and Early Detection Theme, NIHR Manchester Biomedical Research Centre, Manchester, UK.,Manchester Centre for Genomic Medicine, St Mary's Hospital, Division of Evolution and Genomic Sciences, School of Biological Sciences, University of Manchester, Manchester, UK
| | - Philip A J Crosbie
- Division of Infection, Immunity and Respiratory Medicine, The University of Manchester Faculty of Biology Medicine and Health, Manchester, UK .,Prevention and Early Detection Theme, NIHR Manchester Biomedical Research Centre, Manchester, UK.,Manchester Thoracic Oncology Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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Carozzi FM, Bisanzi S, Carrozzi L, Falaschi F, Lopes Pegna A, Mascalchi M, Picozzi G, Peluso M, Sani C, Greco L, Ocello C, Paci E. Multimodal lung cancer screening using the ITALUNG biomarker panel and low dose computed tomography. Results of the ITALUNG biomarker study. Int J Cancer 2017; 141:94-101. [PMID: 28387927 DOI: 10.1002/ijc.30727] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 03/31/2017] [Indexed: 12/19/2022]
Abstract
Asymptomatic high-risk subjects, randomized in the intervention arm of the ITALUNG trial (1,406 screened for lung cancer), were enrolled for the ITALUNG biomarker study (n = 1,356), in which samples of blood and sputum were analyzed for plasma DNA quantification (cut off 5 ng/ml), loss of heterozygosity and microsatellite instability. The ITALUNG biomarker panel (IBP) was considered positive if at least one of the two biomarkers included in the panel was positive. Subjects with and without lung cancer diagnosis at the end of the screening cycle with LDCT (n = 517) were evaluated. Out of 18 baseline screen detected lung cancer cases, 17 were IBP positive (94%). Repeat screen-detected lung cancer cases were 18 and 12 of them positive at baseline IBP test (66%). Interval cancer cases (2-years) and biomarker tests after a suspect Non Calcific Nodule follow-up were investigated. The single test versus multimodal screening measures of accuracy were compared in a simulation within the screened ITALUNG intervention arm, considering screen-detected and interval cancer cases. Sensitivity was 90% at baseline screening. Specificity was 71 and 61% for LDCT and IBP as baseline single test, and improved at 89% with multimodal, combined screening. The positive predictive value was 4.3% for LDCT at baseline and 10.6% for multimodal screening. Multimodal screening could improve the screening efficiency at baseline and strategies for future implementation are discussed. If IBP was used as primary screening test, the LDCT burden might decrease of about 60%.
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Affiliation(s)
- Francesca Maria Carozzi
- Regional Cancer Prevention Laboratory, ISPO-Cancer Prevention and Research Institute, Florence, Italy
| | - Simonetta Bisanzi
- Regional Cancer Prevention Laboratory, ISPO-Cancer Prevention and Research Institute, Florence, Italy
| | - Laura Carrozzi
- Cardiopulmonary Department, University Hospital of Pisa, Pisa, Italy
| | - Fabio Falaschi
- Radiology Department, University Hospital of Pisa, Pisa, Italy
| | | | - Mario Mascalchi
- Radiodiagnostic Section, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Giulia Picozzi
- Radiodiagnostic Unit, ISPO-Cancer Prevention and Research Institute, Florence, Italy
| | - Marco Peluso
- Regional Cancer Prevention Laboratory, ISPO-Cancer Prevention and Research Institute, Florence, Italy
| | - Cristina Sani
- Regional Cancer Prevention Laboratory, ISPO-Cancer Prevention and Research Institute, Florence, Italy
| | - Luana Greco
- Biologist, formerly at ISPO-Cancer Prevention and Research Institute, Florence, Italy
| | | | - Eugenio Paci
- Retired, formerly at ISPO-Cancer Prevention and Research Institute, Florence, Italy
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Mascalchi M, Lopes Pegna A, Carrozzi L, Carozzi F, Falaschi F, Picozzi G, Paci E. Does UKLS strategy increase the yield of screen-detected lung cancers? A comparison with ITALUNG: Table 1. Thorax 2016; 71:950-1. [DOI: 10.1136/thoraxjnl-2016-208409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 04/25/2016] [Indexed: 11/04/2022]
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Fleischhacker M, Schmidt B. Extracellular Nucleic Acids and Cancer. ADVANCES IN PREDICTIVE, PREVENTIVE AND PERSONALISED MEDICINE 2015. [DOI: 10.1007/978-94-017-9168-7_10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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7
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Taylor F, Teare MD, Cox A, Woll PJ. Circulating cell-free DNA: a potential biomarker in lung cancer. Lung Cancer Manag 2013. [DOI: 10.2217/lmt.13.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Cell-free DNA (cfDNA) is a promising, noninvasive tumor ‘liquid biopsy’ with quantitative and qualitative significance. Circulating cfDNA levels are raised in cancer patients and cfDNA exhibits genetic and epigenetic changes found in the underlying tumor. In lung cancer patients, cfDNA levels and tumor-associated genetic and epigenetic changes have been assessed as diagnostic, prognostic and predictive biomarkers. To date, many small studies have been reported with contradictory results. Their interpretation is hampered by differences in methodology and the selection of patients and controls. The treatment of lung cancer is increasingly guided by molecular subtyping, but access to tumor tissue is limited and cfDNA represents an attractive alternative. Moreover, repeated sampling of cfDNA is feasible and cfDNA may be more representative of tumor heterogeneity than a small biopsy sample. However, the establishment of robust and standardized protocols for blood sampling, processing, storage, DNA extraction and analysis are required before cfDNA biomarkers can be utilized in clinical practice.
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Affiliation(s)
- Fiona Taylor
- Academic Unit of Oncology, CR-UK/YCR Sheffield Cancer Research Centre, Weston Park Hospital, Whitham Road, Sheffield, S10 2SJ, UK
| | - M Dawn Teare
- School of Health & Related Research (ScHARR), University of Sheffield, Sheffield, S1 4DA, UK
| | - Angela Cox
- Academic Unit of Molecular Oncology, The Medical School, University of Sheffield, Sheffield, S10 2RX, UK
| | - Penella J Woll
- Academic Unit of Oncology, CR-UK/YCR Sheffield Cancer Research Centre, Weston Park Hospital, Whitham Road, Sheffield, S10 2SJ, UK
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Four-Year Results of Low-Dose CT Screening and Nodule Management in the ITALUNG Trial. J Thorac Oncol 2013; 8:866-75. [DOI: 10.1097/jto.0b013e31828f68d6] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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9
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van Tilborg AAG, Kompier LC, Lurkin I, Poort R, El Bouazzaoui S, van der Keur K, Zuiverloon T, Dyrskjot L, Orntoft TF, Roobol MJ, Zwarthoff EC. Selection of microsatellite markers for bladder cancer diagnosis without the need for corresponding blood. PLoS One 2012; 7:e43345. [PMID: 22927958 PMCID: PMC3425555 DOI: 10.1371/journal.pone.0043345] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 07/19/2012] [Indexed: 01/02/2023] Open
Abstract
Microsatellite markers are used for loss-of-heterozygosity, allelic imbalance and clonality analyses in cancers. Usually, tumor DNA is compared to corresponding normal DNA. However, normal DNA is not always available and can display aberrant allele ratios due to copy number variations in the genome. Moreover, stutter peaks may complicate the analysis. To use microsatellite markers for diagnosis of recurrent bladder cancer, we aimed to select markers without stutter peaks and a constant ratio between alleles, thereby avoiding the need for a control DNA sample. We investigated 49 microsatellite markers with tri- and tetranucleotide repeats in regions commonly lost in bladder cancer. Based on analysis of 50 blood DNAs the 12 best performing markers were selected with few stutter peaks and a constant ratio between peaks heights. Per marker upper and lower cut off values for allele ratios were determined. LOH of the markers was observed in 59/104 tumor DNAs. We then determined the sensitivity of the marker panel for detection of recurrent bladder cancer by assaying 102 urine samples of these patients. Sensitivity was 63% when patients were stratified for LOH in their primary tumors. We demonstrate that up-front selection of microsatellite markers obliterates the need for a corresponding blood sample. For diagnosis of bladder cancer recurrences in urine this significantly reduces costs. Moreover, this approach facilitates retrospective analysis of archival tumor samples for allelic imbalance.
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Affiliation(s)
| | | | - Irene Lurkin
- Department of Pathology, Erasmus MC, Rotterdam, The Netherlands
| | - Ricardo Poort
- Department of Pathology, Erasmus MC, Rotterdam, The Netherlands
| | | | | | | | - Lars Dyrskjot
- Aarhus University Hospital, Department of Clinical Biochemistry, Skejby, Denmark
| | - Torben F. Orntoft
- Aarhus University Hospital, Department of Clinical Biochemistry, Skejby, Denmark
| | | | - Ellen C. Zwarthoff
- Department of Pathology, Erasmus MC, Rotterdam, The Netherlands
- * E-mail:
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Carreras G, Gorini G, Paci E. Can a National Lung Cancer Screening Program in Combination with Smoking Cessation Policies Cause an Early Decrease in Tobacco Deaths in Italy? Cancer Prev Res (Phila) 2012; 5:874-82. [DOI: 10.1158/1940-6207.capr-12-0019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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11
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Carrozzi L, Viegi G. Lung Cancer and Chronic Obstructive Pulmonary Disease: The Story Goes On. Radiology 2011; 261:688-91. [DOI: 10.1148/radiol.11111950] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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12
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Kim CE, Tchou-Wong KM, Rom WN. Sputum-based molecular biomarkers for the early detection of lung cancer: limitations and promise. Cancers (Basel) 2011; 3:2975-89. [PMID: 24212941 PMCID: PMC3759181 DOI: 10.3390/cancers3032975] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 07/11/2011] [Accepted: 07/12/2011] [Indexed: 12/31/2022] Open
Abstract
Lung cancer is the leading cause of cancer deaths, with an overall survival of 15% at five years. Biomarkers that can sensitively and specifically detect lung cancer at early stage are crucial for improving this poor survival rate. Sputum has been the target for the discovery of non-invasive biomarkers for lung cancer because it contains airway epithelial cells, and molecular alterations identified in sputum are most likely to reflect tumor-associated changes or field cancerization caused by smoking in the lung. Sputum-based molecular biomarkers include morphology, allelic imbalance, promoter hypermethylation, gene mutations and, recently, differential miRNA expression. To improve the sensitivity and reproducibility of sputum-based biomarkers, we recommend standardization of processing protocols, bronchial epithelial cell enrichment, and identification of field cancerization biomarkers.
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Affiliation(s)
- Connie E. Kim
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine. 462 First Avenue, NBV 7N24, New York, NY 10016, USA; E-Mails: (C.E.K.); (K.-M.T.-W.)
| | - Kam-Meng Tchou-Wong
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine. 462 First Avenue, NBV 7N24, New York, NY 10016, USA; E-Mails: (C.E.K.); (K.-M.T.-W.)
- Department of Environmental Medicine, New York University School of Medicine, 57 Old Forge Road, Tuxedo, NY 10987, USA
| | - William N. Rom
- Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine. 462 First Avenue, NBV 7N24, New York, NY 10016, USA; E-Mails: (C.E.K.); (K.-M.T.-W.)
- Department of Environmental Medicine, New York University School of Medicine, 57 Old Forge Road, Tuxedo, NY 10987, USA
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: 212-263-6479; Fax: 212-263-8442
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13
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Aisner DL, Theodorescu D. Genetic testing for metastasis: potential for improved cancer treatment. Future Oncol 2011; 7:697-701. [PMID: 21675831 DOI: 10.2217/fon.11.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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