Serum anti-p53 antibodies in lung cancer: comparison with established tumor markers

Label-free electrochemical detection of cancer biomarkers DNA and anti-p53 at tin oxide quantum dot-gold-DNA nanoparticle modified electrode

Lung cancer is one of the deadliest types of cancer and accounts for 8.1% of all cancer related deaths. To prevent a growing death rate, it is crucial to identify lung cancer at an early stage by single polynucleotide morphism detection. In this paper, we present a novel label-free electrochemical biosensor based on composites of tin oxide quantum dots and gold nanoparticles (SnO₂-QD-Au) for the sensitive and precise detection of lung cancer DNA. The SnO₂-QD and SnO₂-QD-Au nanoparticles were characterized using Scanning and Transmission Electron Microscopes (SEM and TEM), X-ray diffractometer (XRD), X-ray photoelectron spectroscopy (XPS), UV-Vis spectroscopy (UV), Fourier transmission infrared spectroscopy (FTIR), cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) techniques. Gold thiol covalent bonding was used for immobilising probe DNA on the surface of SnO₂-QD-Au nanoparticles followed by target DNA hybridization and detected electrochemically in presence of 1 mM [Fe(CN₆)]^3-/4-as a redox couple probe. Under ideal circumstances, the sensor showed the lowest detection limit of 3.2 × 10^-20 M with a linear range of 1 × 10^-6 - 1 × 10^-20 M. Additionally, the sensing method was applied to find a cancer biomarker, Anti-P53 antibody.

Construction of a ternary nano-architecture based graphene oxide sheets, toward electrocatalytic determination of tumor-associated anti-p53 autoantibodies in human serum

Almost 13% of all death in the world is related to cancer. One of the major reasons for failing cancer treatment is the late diagnosis of the tumors. Thus, diagnosis at the early stages could be vital for the treatment. Serum autoantibodies, as tumor markers, are becoming interesting targets due to their medical and biological relevance. Among them, anti-p53 autoantibody in human sera is found to be involved in a variety of cancers. Regarding this issue, a novel and sensitive electrochemical biosensor for detection of anti-p53 autoantibody has been developed. For this purpose, a nanocomposite including thionine (as an electron transfer mediator)/chitosan/nickel hydroxide nanoparticles/electrochemically reduced graphene oxide (Th-CS-Ni(OH)₂NPs-ERGO) as a support platform was fabricated on the surface of glassy carbon electrode via a layer-by-layer manner and characterized through common electrochemical and imaging techniques. Then, p53-antigen was immobilized on the nanocomposite and used in an indirect immunoassay with horseradish peroxidase (HRP)-conjugated secondary antibody and H₂O₂ as the substrate, following the typical Michaelis-Menten kinetics. Under optimized condition, two techniques, including differential Pulse Voltammetry (DPV) and Electrochemical Impedance Spectroscopy (EIS) as a label free technique, applied for the biomarker detection. The linear ranges and LODs were obtained 0.1-500 pg mL^-1 and 0.001 pg mL^-1 using DPV and 5-150 pg mL^-1 and 0.007 pg mL^-1 using EIS, respectively. Furthermore, the proposed biosensor displayed satisfying stability, selectivity, and reproducibility. According to the results, the presented protocol is promising to develop other electrochemical biosensors.

A potential-resolved electrochemiluminescence resonance energy transfer strategy for the simultaneous detection of neuron-specific enolase and the cytokeratin 19 fragment

An electrochemiluminescence resonance energy transfer (ECL-RET) immunosensor was developed based on the potential-resolved technology for the simultaneous detection of neuron-specific enolase (NSE) and the cytokeratin 19 fragment (CYFRA21-1). The absorption spectrum of gold nanorods (AuNRs) perfectly overlapped with the ECL spectra of SnS2@Pt and Ru(bpy)32+/Zn-MOF, so they exhibited an excellent ECL-RET effect with high efficiency. Zn-MOF possesses a large surface area, which allows for the loading of Ru(bpy)32+. This results in a signal probe of Ru(bpy)32+/Zn-MOF/Ab1 showing a strong ECL emission. Simultaneously, owing to the excellent electronic conductivity of PtNPs, they can increase the electron transfer rate between S2O82- and tin disulfide nanoflowers (SnS2NFs). Hence, the ECL signal of SnS2NFs can be enhanced. Under the optimal conditions, the linear range for NSE is 0.2 pg mL-1-20 ng mL-1 with a detection limit of 79 fg mL-1. The linear range for CYFRA21-1 is 1.25 pg mL-1-12.5 ng mL-1 with a detection limit of 0.43 pg mL-1. The proposed immunosensor can be used for the sensitive simultaneous detection of NSE and CYFRA21-1 in human serum and has promise for clinical diagnostics.

Highly sensitive detection of carcinoembryonic antigen using copper-free click chemistry on the surface of azide cofunctionalized graphene oxide

In this study, we reported a highly sensitive method for detecting carcinoembryonic antigen (CEA) based on an azide cofunctionalized graphene oxide (GO-N₃) and carbon dot (CDs) biosensor system. Carbon dots-labeled DNA (CDs-DNA) combined with GO-N₃ using copper-free click chemistry (CFCC), which quenched the fluorescence of the CDs via fluorescence resonance energy transfer (FRET). Upon the addition of CEA, fluorescence was recovered due to the combination of CEA and aptamer. Under optimal conditions, the relative fluorescence intensity was linear with CEA concentration in the range of 0.01-1 ng/mL (R² = 0.9788), and the limit of detection (LOD) was 7.32 pg/mL (S/N = 3). This biosensor had a high sensitivity and good selectivity for CEA detection in serum samples, indicating that the novel sensor platform holds a great potential for CEA and other biomarkers in practical applications.

Autoantibodies as diagnostic biomarkers for lung cancer: A systematic review

Lung cancer (LC) accounts for the largest number of tumor-related deaths worldwide. As the overall 5-year survival rate of LC is associated with its stages at detection, development of a cost-effective and noninvasive cancer screening method is necessary. We conducted a systematic review to evaluate the diagnostic values of single and panel tumor-associated autoantibodies (TAAbs) in patients with LC. This review included 52 articles with 64 single TAAbs and 19 with 20 panels of TAAbs. Enzyme-linked immunosorbent assays (ELISA) were the most common detection method. The sensitivities of single TAAbs for all stages of LC ranged from 3.1% to 92.9% (mean: 45.2%, median: 37.1%), specificities from 60.6% to 100% (mean: 88.1%, median: 94.9%), and AUCs from 0.416 to 0.990 (mean: 0.764, median: 0.785). The single TAAb with the most significant diagnostic value was the autoantibody against human epididymis secretory protein (HE4) with the maximum sensitivity 91% for NSCLC. The sensitivities of the panel of TAAbs ranged from 30% to 94.8% (mean: 76.7%, median: 82%), specificities from 73% to 100% (mean: 86.8%, median: 89.0%), and AUCs from 0.630 to 0.982 (mean: 0.821, median: 0.820), and the most significant AUC value in a panel (M13 Phage 908, 3148, 1011, 3052, 1000) was 0.982. The single TAAb with the most significant diagnostic calue for early stage LC, was the autoantibody against Wilms tumor protein 1 (WT1) with the maximum sensitivity of 90.3% for NSCLC and its sensitivity and specificity in a panel (T7 Phage 72, 91, 96, 252, 286, 290) were both above 90.0%. Single or TAAbs panels may be useful biomarkers for detecting LC patients at all stages or an early-stage in high-risk populations or health people, but the TAAbs panels showed higher detection performance than single TAAbs. The diagnostic value of the panel of six TAAbs, which is higher than the panel of seven TAAbs, may be used as potential biomarkers for the early detection of LC and can probably be used in combination with low-dose CT in the clinic.

Early detection of lung cancer biomarkers through biosensor technology: A review

Lung cancer is undoubtedly one of the most serious health issues of the 21 st century. It is the second leading cause of cancer-related deaths in both men and women　worldwide, accounting for about 1.5 million deaths annually. Despite advances in the treatment of lung cancer with new pharmaceutical products and technological improvements, morbidity and mortality rates remains a significant challenge for the cancer biologists and oncologists. The vast majority of lung cancer patients present with advanced-stage of pathological process that ultimately leads to poor prognosis and a five-year survival rate less than 20%. Early and accurate screening and analysis using cost-effective means are urgently needed to effectively diagnose the disease, improve the survival rate or to reduce mortality and morbidity associated with lung cancer patients. Thus, the only hope for early recognition of risk factors and timely diagnosis and treatment of lung cancer is biosensors technology. Novel biosensing based diagnostics approaches for predicting metastatic risks are likely to have significant therapeutic and clinical impact in the near future. This article systematically provides a brief overview of various biosensing platforms for identification of lung cancer disease biomarkers, with a specific focus on recent advancements in electrochemical and optical biosensors, analytical performances of different biosensors, challenges and further research opportunities for routine clinical analysis.

Recent developments in dopamine-based materials for cancer diagnosis and therapy

Dopamine-based materials are emerging as novel biomaterials and have attracted considerable interests in the fields of biosensing, bioimaging and cancer therapy due to their unique physicochemical properties, such as versatile adhesion property, high chemical reactivity, excellent biocompatibility and biodegradability, strong photothermal conversion capacity, etc. In this review, we present an overview of recent research progress on dopamine-based materials for diagnosis and therapy of cancer. The review starts with a summary of the physicochemical properties of dopamine-based materials in general. Then detailed description is followed on their applications in the fields of diagnosis and treatment of cancers. The review concludes with an outline of some remaining challenges for dopamine-based materials to be used for clinical applications.

Elevation of TP53 Autoantibody Before CA125 in Preclinical Invasive Epithelial Ovarian Cancer

Purpose: The TP53 tumor-suppressor gene is mutated in >95% of high-grade serous ovarian cancers. Detecting an autologous antibody response to TP53 that might improve early detection.Experimental Design: An immunoassay was developed to measure TP53 autoantibody in sera from 378 cases of invasive epithelial ovarian cancer and 944 age-matched healthy controls from the United States, Australia, and the United Kingdom. Serial preclinical samples from cases and controls were also assayed from the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).Results: Using a cutoff value of 78 U/mL to achieve a specificity of 97.4%, TP53 autoantibody was elevated in 30% of 50 cases from MD Anderson, 21.3% of 108 cases from the Australian Ovarian Cancer Study, and 21% of 220 cases from the UKCTOCS. Among 164 cases with rising CA125 detected with the UKCTOCS risk of ovarian cancer algorithm (ROCA), 20.7% had elevated TP53 autoantibody. In cases missed by the ROCA, 16% of cases had elevated TP53 autoantibody. Of the 34 ovarian cancer cases detected with the ROCA, TP53 autoantibody titers were elevated 11.0 months before CA125. In the 9 cases missed by the ROCA, TP53 autoantibody was elevated 22.9 months before cancer diagnosis. Similar sensitivity was obtained using assays with specific mutant and wild-type TP53.Conclusions: TP53 autoantibody levels provide a biomarker with clinically significant lead time over elevation of CA125 or an elevated ROCA value. Quantitative assessment of autoantibodies in combination with CA125 holds promise for earlier detection of invasive epithelial ovarian cancer. Clin Cancer Res; 23(19); 5912-22. ©2017 AACR.

Serum tumor-associated autoantibodies as diagnostic biomarkers for lung cancer: A systematic review and meta-analysis

OBJECTIVE

We performed a comprehensive review and meta-analysis to evaluate the diagnostic values of serum single and multiplex tumor-associated autoantibodies (TAAbs) in patients with lung cancer (LC).

METHODS

We searched the MEDLINE and EMBASE databases for relevant studies investigating serum TAAbs for the diagnosis of LC. The primary outcomes included sensitivity, specificity and accuracy of the test.

RESULTS

The systematic review and meta-analysis included 31 articles with single autoantibody and 39 with multiplex autoantibodies. Enzyme-linked immunosorbent assay (ELISA) was the most common detection method. For the diagnosis of patients with all stages and early-stage LC, different single or combinations of TAAbs demonstrated different diagnostic values. Although individual TAAbs showed low diagnostic sensitivity, the combination of multiplex autoantibodies offered relatively high sensitivity. For the meta-analysis of a same panel of autoantibodies in patients at all stages of LC, the pooled results of the panel of 6 TAAbs (p53, NY-ESO-1, CAGE, GBU4-5, Annexin 1 and SOX2) were: sensitivity 38% (95% CI 0.35-0.40), specificity 89% (95% CI 0.86-0.91), diagnostic accuracy 65.9% (range 62.5-81.8%), AUC 0.52 (0.48-0.57), while the summary estimates of 7 TAAbs (p53, CAGE, NY-ESO-1, GBU4-5, SOX2, MAGE A4 and Hu-D) were: sensitivity 47% (95% CI 0.34-0.60), specificity 90% (95% CI 0.89-0.92), diagnostic accuracy 78.4% (range 67.5-88.8%), AUC 0.90 (0.87-0.93). For the meta-analysis of the same panel of autoantibodies in patients at early-stage of LC, the sensitivities of both panels of 7 TAAbs and 6 TAAbs were 40% and 29.7%, while their specificities were 91% and 87%, respectively.

CONCLUSIONS

Serum single or combinations of multiplex autoantibodies can be used as a tool for the diagnosis of LC patients at all stages or early-stage, but the combination of multiplex autoantibodies shows a higher detection capacity; the diagnostic value of the panel of 7 TAAbs is higher than the panel of 6 TAAbs, which may be used as potential biomarkers for the early detection of LC.

Au nanoparticle decorated graphene nanosheets for electrochemical immunosensing of p53 antibodies for cancer prognosis

Thiolated self-assembled reduced graphene oxide films were decorated with gold nanoparticles for development of a label-free p53-antibody immunosensor.

Prognostic role of serum p53 antibodies in lung cancer

BACKGROUND

Mutations in the TP53 (Tumour Protein 53) gene can lead to expression of mutant p53 proteins that accumulate in cancer cells and can induce circulating p53 antibodies in cancer patients. Our aim was to evaluate the presence and prognostic role of these antibodies in lung cancer patients and to investigate whether they were related to p53 expression or TP53 mutations in tumour tissues.

METHODS

A total of 201 lung cancer patients were evaluated for p53 antibodies by ELISA (Enzyme-Linked Immunosorbent Assay) and control was obtained from 54 patients with non-malignant disorders; p53 expression was evaluated in 131 of the lung cancer patients by immunohistochemistry and TP53 mutations were then investigated in 53 tumours positively staining for p53 and in 12 tumours without p53 overexpression, whose DNA was available for direct sequencing.

RESULTS

Our results show that 20.4% of cancer patients have positive levels of p53 antibodies, while none of the controls resulted positive. High levels of p53 expression are detected in 57.3% of cases and a significant correlation between serum p53 antibodies and high levels of p53 expression in the corresponding tumours is observed. In non-small cell lung cancer, p53 antibodies are significantly associated with poorly differentiated tumours; furthermore, high levels of p53 expression significantly correlated with squamous cell carcinoma and tumours with highest grade. Survival time of non-small cell lung cancer patients low/negative for serum p53 antibodies was significantly longer compared to patients with positive levels (p = 0.049); in particular, patients with squamous cell carcinoma, but not adenocarcinoma, low/negative for these antibodies show a significant better survival compared to serum-positive patients (p = 0.044).

CONCLUSIONS

In our study, detection of serum p53 antibodies in non-small cell lung cancer patients has been shown to be useful in identifying subsets of patients with poor prognosis. A significant correlation between the presence of serum p53 antibodies in lung cancer patients and p53 overexpression in the corresponding tumours was also observed. We did not find a significant correlation between levels of serum p53 antibodies and TP53 mutations in the corresponding tumours.

Nanomaterial-Based Electrochemical Immunosensors for Clinically Significant Biomarkers

Nanotechnology has played a crucial role in the development of biosensors over the past decade. The development, testing, optimization, and validation of new biosensors has become a highly interdisciplinary effort involving experts in chemistry, biology, physics, engineering, and medicine. The sensitivity, the specificity and the reproducibility of biosensors have improved tremendously as a result of incorporating nanomaterials in their design. In general, nanomaterials-based electrochemical immunosensors amplify the sensitivity by facilitating greater loading of the larger sensing surface with biorecognition molecules as well as improving the electrochemical properties of the transducer. The most common types of nanomaterials and their properties will be described. In addition, the utilization of nanomaterials in immunosensors for biomarker detection will be discussed since these biosensors have enormous potential for a myriad of clinical uses. Electrochemical immunosensors provide a specific and simple analytical alternative as evidenced by their brief analysis times, inexpensive instrumentation, lower assay cost as well as good portability and amenability to miniaturization. The role nanomaterials play in biosensors, their ability to improve detection capabilities in low concentration analytes yielding clinically useful data and their impact on other biosensor performance properties will be discussed. Finally, the most common types of electroanalytical detection methods will be briefly touched upon.

Usefulness of serum anti-p53 antibody assay for lung cancer diagnosis

CONTEXT

Some tumor markers, including carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA 21-1), are used for the detection of lung cancer; however, their use is limited because of low sensitivities and high false-positive rates.

OBJECTIVES

To investigate the usefulness of an anti-p53 assay in detecting lung cancer and to compare the anti-p53 to CEA and CYFRA 21-1 tumor markers.

DESIGN

Serum samples were collected from 82 patients with lung cancer. Sera were also collected from 79 patients with or without benign pulmonary disease for the control group. All 161 specimens were assayed for CEA, CYFRA 21-1, and anti-p53. The diagnostic performances of these markers were compared using receiver operating characteristic analysis.

RESULTS

The receiver operating characteristic area under the curve values of CYFRA 21-1, CEA, and anti-p53 for discriminating lung cancers from benign or healthy conditions were 0.79, 0.81, and 0.79, respectively. Area under the curve for the 3 markers in combination was 0.90. The sensitivities of those markers for lung cancer detection were respectively 39.0%, 53.7%, and 34.1% at 94.9% specificity, and the cutoff levels at those sensitivities and specificities were 4.5 ng/mL for CYFRA 21-1, 5.4 ng/mL for CEA, and 2.7 U/mL for anti-p53. We found 79.3% positive results for patients with lung cancer by any of the 3 markers, and 12.2% were positive only for anti-p53. All patients without cancer had negative results for 2 or all 3 markers.

CONCLUSIONS

Anti-p53 combined with other conventional markers is helpful in increasing the sensitivity and specificity for detecting lung cancer.

Multiarmed star-like platinum nanowires with multienzyme assembly for direct electronic determination of carcinoembryoninc antigen in serum

A new electrochemical immunoassay strategy for direct detection of carcinoembryoninc antigen (CEA) in serum was developed by using multiarmed star-like platinum nanowires (PtNWs) with biomolecular assembly as signal tags on an anti-CEA-functionalized graphene sensing platform. Initially, the PtNWs were synthesized via a wet chemical method, and then the synthesized PtNWs were used for the co-immobilization of CEA and horseradish peroxidase (HRP). Compared with platinum nanoparticles, the prepared PtNWs could provide a large room for the conjugation of HRP and CEA. With a competitive-type immunoassay format, the assay was performed in two types of supporting electrolytes including new born cattle serum (NBCS) and acetate buffer solution (ABS, pH 5.5), respectively. Similar detection limit (LOD) of 5.0 pg mL(-1) vs. 1.0 pg mL(-1) but narrower dynamic working linear range of 0.01-60 ng mL(-1) vs. 0.002-80 ng mL(-1) was obtained toward CEA standards in the NBCS compared to the ABS. The intra-assay coefficients of variation (CVs) were 4.3%, 8.6%, and 6.2% at 0.05, 10, and 40 ng mL(-1) CEA, respectively, while the inter-assay CVs were 7.6%, 10.5%, and 8.9% at the above-mentioned levels, respectively. In addition, the selectivity and stability of the electrochemical immunosensor were acceptable. Importantly, the developed method was used to assay clinical serum specimens, receiving a good relation with those obtained from the referenced method.

Dickkopf-1 autoantibody is a novel serological biomarker for non-small cell lung cancer

OBJECTIVE

We investigated whether or not there are autoantibodies for DKK1 (Dickkopf-1) in patients with non-small cell lung cancer (NSCLC) and whether this autoantibody can be used for cancer detection.

METHODS

The levels of DKK1 autoantibodies were determined in 93 NSCLC patients and 87 healthy controls.

RESULTS

We found that, in the sera, the presence of autoantibody against DKK1 was highly correlated with NSCLC. High anti-DKK1 autoantibody titres were found in the sera of NSCLC patients, whereas low or negative titres were found in the control group. The ROC curve results showed that autoantibody immunoassay exhibited 62% sensitivity and 84% specificity. The sensitivity for the detection of NSCLC in stage I also reach 64.3%. Furthermore, a combined ELISA assays for both DKK1 and autoantibody DKK1 increased sensitivity and classified 81.7% (76/93) of the NSCLC patients as positive, whereas only 13.8 % (12/87) of healthy volunteers were falsely diagnosed as positive.

CONCLUSIONS

Our results suggest that the detection of circulating DKK1 autoantibody could potentially serve as a useful non-invasive marker for determining lung cancer status.

Autoantibody profiling for cancer detection

Despite substantial progress in the understanding of the pathogenesis of cancer, the development and implementation of strategies for early cancer detection have lagged behind. Harnessing the immune response to tumor antigens is particularly useful for early detection because the immune response occurs early during tumor development and affords signal amplification with the end product, namely reactive immunoglobulins, being released into the circulation allowing easy access through the blood. This article presents recent developments in autoantibody profiling with a focus on proteomic approaches and applications to lung cancer.

A sensitive amperometric immunosensor for carcinoembryonic antigen detection with porous nanogold film and nano-Au/chitosan composite as immobilization matrix

A sensitive amperometric immunosensor for carcinoembryonic antigen (CEA) was prepared. Firstly, a porous nano-structure gold (NG) film was formed on glassy carbon electrode (GCE) by electrochemical reduction of HAuCl4 solution, then nano-Au/Chit composite was immobilized onto the electrode because of its excellent membrane-forming ability, and finally the anti-CEA was adsorbed onto the surface of the bilayer gold nanoparticles to construct an anti-CEA/nano-Au/Chit/NG/GCE immunosensor. The characteristics of the modified electrode at different stages of modification were studied by cyclic voltammetry (CV). The gold colloid, chitosan and nano-Au/Chit were characterized by transmission electron microscopy and UV-vis spectroscopy. In addition, the performances of the immunosensor were studied in detail. The resulting immunosensor offers a high-sensitivity (1310 nA/ng/ml) for the detection of CEA and has good correlation for detection of CEA in the range of 0.2 to 120.0 ng/ml with a detection limit of 0.06 ng/ml estimated at a signal-to-noise ratio of 3. The proposed method can detect the CEA through one-step immunoassay and would be valuable for clinical immunoassay.

Oncogene and tumor-suppressor gene products as serum biomarkers in occupational-derived lung cancer

Since lung cancer is the most frequent occupational cancer and one of the leading causes of cancer mortality in the world, it is one of the biggest challenges for research. In the literature, there are inconsistent results regarding the utility of the serum biomarkers p53, anti-p53 antibodies, EGF receptor or Ras. Based on the published results, routine use of these biomarkers for detection of occupationally derived lung carcinomas is not currently recommended. In this review, we summarize the literature and discuss the relevance of these oncogene and tumor-suppressor gene products as serum biomarkers in occupational-derived lung cancer.

Recommendations For Clinical Use Of Tumor Markers In Lung Cancer

Kancer pluća predstavlja jedan od najozbiljnijih problema moderne onkologije. Uprkos kontinuiranom napretku u dijagnostičkim metodama, kod 50-70% pacijenata s kancerom pluća, bolest se dijagnostikuje u uznapredovalom stadijumu, isključujuci na taj način mogućnost radikalne terapije. Određivanje tumorskih markera kod kancera pluća može biti od pomoći u postavljanju dijagnoze, praćenju pacijenta i terapije, a takođe može da pruži dodatne informacije u prognostičke svrhe. U daljem tekstu opisani su odgovarajući serumski markeri kod dve glavne forme tumora pluća-mikrocelularnog i nemikrocelularnog (SCLC i NSCLC), kao i abnormalne supstance identifikovane u tumorima pluća ili njihovim metastazama, kao što su molekularni markeri, markeri prognoze u primeni neoadjuvantne ili adjuvantne terapije i mikrometastazama koštane srži ili limfnom čvoru.

Electrochemical Immunosensor for Carcinoembryonic Antigen Based on Antigen Immobilization in Gold Nanoparticles Modified Chitosan Membrane

A disposable electrochemical immunosensor for carcinoembryonic antigen (CEA) was proposed based on the antigen immobilized in a colloidal gold nanoparticles modified chitosan membrane on the surface of an indium-tin oxide (ITO) electrode. The different membranes were characterized by scanning electron microscope and electrochemical methods. Based on a competitive immunoassay format, the immobilized antigen of the immunosensor was incubated with a horseradish peroxidase (HRP) labeled antibody and sample CEA antigen, and the formed immunoconjugate in the immunosensor was detected by an o-phenylenediamine-H(2)O(2)-HRP electrochemical system. Under the optimal experimental conditions, the electrocatalytic current decreased linearly with the competitive mechanism. CEA could be determined in the linear range from 2.0 to 20 ng/ml with a detection limit of 1.0 ng/ml. The prepared CEA immunosensor is not only economic due to the low-cost ITO electrode obtained from industrial mass production, but is also capable with good stability and reproducibility for batch fabrication.

Tumor markers in detection of lung cancer

The expression of biomarkers by lung cancers is useful in the diagnosis and clinical management of patients with lung cancer. Biomarkers provide insight into histogenesis, interrelationships, and biological behavior of lung tumors. This chapter presents data on lung cancer detection, involving some of the most studied and interesting lung cancer biomarkers to date-CYFRA 21-1, NSE, ProGRP, SCC, CEA, Tumor M2-PK, as well as markers in clinical application such as CRP, LDH, tumor-suppressor genes and oncogenes, CA125, CgA, NCAM, and TPA. Biomarker profiles in combination with fuzzy logic techniques have also been addressed. Serum markers used alone or in combination with other indices might play an important role in monitoring response to therapy in early detection of tumor reactivation in new treatment strategies as well as in secondary prevention.

The Presence of Serum Anti-p53 Antibodies from Patients with Invasive Ductal Carcinoma of Breast: Correlation to Other Clinical and Biological Parameters

Breast cancer has been the most common malignant tumor among women in many large cities of China. The aim of this study was to clarify the prognostic significance of serum anti-p53 antibodies (p53 Abs) in Chinese patients of breast cancer. One hundred and forty-four patients with invasive ductal carcinoma of breast were involved in this study. The expressions of ER, PR, c-erbB-2 and p53 were immunostained in tumor tissues and serum p53 Abs were assayed using ELISA method. The correlations between p53 Abs and other clinical and biological markers were analyzed. Among 144 patients, 31 (21.5%) had positive p53 Abs, which was associated with several poor prognostic parameters including higher clinical stage (p = 0.0233), lymph nodes metastasis (p = 0.0033), negative ER expression (p = 0.0250) and positive c-erbB-2 status (p = 0.0227). There was also a strong correlation between p53 Abs and tumor p53 positivity (p < 0.0001). These results indicated that the presence of p53 Abs is probably triggered by the accumulation of tumor p53 protein, and it could be a useful marker to complement routine prognostic factors in breast cancer patients.

Peroxiredoxin-I is an autoimmunogenic tumor antigen in non-small cell lung cancer

In eukaryotic cells, peroxiredoxins are both antioxidants and regulators of H(2)O(2)-mediated signaling. We previously found that peroxiredoxin-I (Prx-I) was overexpressed in non-small cell lung cancer (NSCLC) tissue. Since overexpressed protein can induce a humoral immune response, we examined whether serum from NSCLC patients exhibited immunoreactivity against Prx-I using Western blotting. We found that 25 (47%) of 53 NSCLC patients tested had autoantibodies against Prx-I in their sera, whereas such activity was detected in 4 (8%) sera from 50 healthy subjects. Prx-I itself was detected in the sera from 18 (34%) of 53 NSCLC patients but in only 1 (2%) serum from 50 controls. Moreover, 17% of NSCLC sera were positive to both Prx-I antibody and antigen but none in control sera. The data indicate both Prx-I autoantibody and circulating antigen are potential biomarkers for use in serological diagnosis of NSCLC. Interestingly enough, we found that Prx-I was secreted by lung adenocarcinoma cells (A549) but not by non-cancer lung cells (BEAS 2B) or breast cancer cells (MCF7). This cell culture study suggests the possibility of Prx-I secretion from NSCLC tumor tissues.

Electrochemical sensor for immunoassay of carcinoembryonic antigen based on thionine monolayer modified gold electrode

A sensor based on thionine monolayer modified gold electrode for determination of carcinoembryonic antigen (CEA) in human serum is proposed. The sensor is prepared by covalently binding thionine to a cysteamine self-assembled monolayer with p-phthaloyl chloride as a linkage, which gives a surface coverage of 8.97+/-3.28 x 10(-12)mol/cm(2) for thionine. The electrochemistry of the immobilized thionine displays a surface-controlled electrode process with an average electron transfer rate constant of 1.47+/-0.84 s(-1). Based on an electrochemical enzyme-linked immunoassay by using the immobilized thionine as an electron transfer mediator between the electrode and the horseradish peroxidase (HRP) labeled anti-CEA antibody, a calibration curve with two linear ranges from 0.6 to 17 and 17 to 200 ng/mL and a detection limit of 0.2 ng/mL for CEA determination is obtained in pH 4.2 PBS containing 2.0 mmol/L H(2)O(2) and 0.5 mol/L NaCl. The sensor shows a good accuracy. The precision and reproducibility are acceptable with the intra-assay CV of 4.9% and 5.9% at 10 and 100 ng/mL CEA concentrations, respectively, and the inter-assays CV of 7.8% at 100 ng/mL CEA. The response of thionine modified electrode shows only 1.6% decrease after 100 replicate measurements and the storage stability is acceptable in a pH 7.0 PBS at 4 degrees C for 1 week. The method avoids the addition of electron transfer mediator to the solution, thus is much simpler. The proposed method would be valuable for the diagnosis and monitoring of carcinoma and its metastasis.

Molecular classification and molecular genetics of human lung cancers

Recent advances in the molecular classification of lung carcinomas and the identification of causative genetic alterations will likely lead to improvements in the diagnosis and treatment of patients with lung cancer. It is now possible to identify gene expression profiles that associate with patient outcome in lung carcinomas, in particular adenocarcinoma. Furthermore, patient survival has been shown to correlate with lung cancer oligonucleotide microarray expression profiles. Large-scale microarray technology may allow for the identification of useful biomarkers for early cancer detection. Oligonucleotide microarray data can be optimized by relating them to protein expression levels in tissue microarrays, by annotation with mutational data, and with results of testing for post-translational modification of cellular proteins. These data may be useful in tailoring chemotherapeutic protocols to individual tumors and identifying new targets for therapeutic intervention.

Titration of serum p53 antibodies in 1,085 patients with various types of malignant tumors: a multiinstitutional analysis by the Japan p53 Antibody Research Group

BACKGROUND

There have been very few large-scale, multiinstitutional studies of surveillance of serum p53 antibodies (S-p53 Abs) in patients with various malignant tumors.

METHODS

A highly specific, quantitative enzyme-linked immunosorbent assay (ELISA) kit was developed and used to evaluate the efficiency of detecting p53 Abs. A cut-off value was established by analyzing sera from 205 healthy volunteers as reference individuals. Sera from 1085 patients with various types of primary malignant tumors were studied for the presence of S-p53 Abs before treatment. Sera from 34 patients were selected randomly for a competition assay to ensure that antibodies were specific to p53 protein. Carcinoembryonic antigen (CEA) was assessed to compare its positive rate with the positive rate of S-p53 Abs.

RESULTS

The median value of S-p53 Abs in healthy control individuals was 0.33 U/mL (range, 0.0-4.39 U/mL). Based on reference values that were calculated using parametric determination of the lower 0.95 fraction of the reference distribution in healthy control individuals, the cut-off value was determined as 1.3 U/mL. Two hundred twenty-one of 1085 patients (20.4%) were positive for S-p53 Abs. The highest relevance of S-53 Abs was associated with head and neck carcinoma (32%), followed by esophageal carcinoma (30%), colorectal carcinoma (24%), and carcinoma of the uterus (23%). The positive rate for S-p53 Abs was higher compared with the positive rate for CEA in patients with squamous cell carcinoma.

CONCLUSIONS

Surveillance of S-p53 Abs is useful in detecting various types of malignant tumors, particular in patients with squamous cell carcinoma.

Lung cancer staging

Accurate staging of lung cancer is essential for proper treatment and management of the disease, and allows predictions for patient survival. Several different invasive and noninvasive modalities exist for staging, and the determination of the best approach of one or a combination of those methods depends on the clinical situation and the clinician's assessment of the most appropriate means of staging evaluation. This review discusses the elements and framework of lung cancer staging, with particular emphasis on those newer modalities, especially positron emission tomography and endoscopic ultrasound needle biopsy, which will be expected to be used increasingly more common in clinical practice.