[Overexpression of IL-8 and MMP-9 confer high malignant phenotype in patients with non-small cell lung cancer]

Blood test shows high accuracy in detecting stage I non-small cell lung cancer

Background

In a previous study (Goebel et. al, Cancer Genomics Proteomics 16:229-244, 2019), we identified 33 biomarkers for an early stage (I-II) Non-Small Cell Lung Cancer (NSCLC) test with 90% accuracy, 80.3% sensitivity, and 95.4% specificity. For the current study, we used a narrowed ensemble of 21 biomarkers while retaining similar accuracy in detecting early stage lung cancer.

Methods

A multiplex platform, 486 human plasma samples, and 21 biomarkers were used to develop and validate our algorithm which detects early stage NSCLC. The training set consisted of 258 human plasma with 79 Stage I-II NSCLC samples. The 21 biomarkers with the statistical model (Lung Cancer Detector Test 1, LCDT1) was then validated using 228 novel samples which included 55 Stage I NSCLC.

Results

The LCDT1 exhibited 95.6% accuracy, 89.1% sensitivity, and 97.7% specificity in detecting Stage I NSCLC on the blind set. When only NSCLC cancers were analyzed, the specificity increased to 99.1%.

Conclusions

Compared to current approved clinical methods for diagnosing NSCLC, the LCDT1 greatly improves accuracy while being non-invasive; a simple, cost-effective, early diagnostic blood test should result in expanding access and increase survival rate.

Prognostic impact of serum and tissue MMP-9 in non-small cell lung cancer: a systematic review and meta-analysis

Matrix metalloproteinases-9 (MMP-9) was one of the most important enzyme to breakdown extracellular matrix, aim to clarify the prognostic value of MMP-9 in non-small cell lung cancer (NSCLC), we investigated the serum MMP-9 of NSCLC patients and performed a meta-analysis of the published literature. The expression and activity of serum MMP-9 were assessed by ELISA and gelatin zymography in 163 NSCLC patients. Moreover, 26 studies were included in meta-analysis by searching Medline and ISI Web of Knowledge. Our own data revealed high activity but not expression of MMP-9 significantly correlated with advanced T category and positive metastasis. In contrast, the meta-analysis revealed that increased MMP-9 level indicate high T category (RR = 0.83, 95% CI: 0.73-0.94), tumor stage (RR = 0.72, 95% CI: 0.63-0.82) and poor OS (5-year overall survival, RR = 1.32, 95% CI: 1.19-1.48). Moreover, stratified analysis based on sample types found that high MMP-9 expression in tissue specimen but not serum was significant correlated with advanced T category (RR = 0.81, 95% CI: 0.72-0.92), tumor stage (RR = 0.69, 95% CI: 0.60-0.80) and poor 5-year OS (1.33, 95% CI: 1.18-1.50).In conclusion, the activity of MMP-9 was positively correlated with advanced T category and distant metastasis. Moreover, the meta-analysis revealed that overexpression of MMP-9 in tissue but not in serum was a risk factor of advanced T category, tumor stage and poor outcome.

Interaction between lung cancer cells and astrocytes via specific inflammatory cytokines in the microenvironment of brain metastasis

The incidence of brain metastasis is increasing, however, little is known about molecular mechanism responsible for lung cancer-derived brain metastasis and their development in the brain. In the present study, brain pathology was examined in an experimental model system of brain metastasis as well as in human brain with lung cancer metastasis. In an experimental model, after 3–6 weeks of intracardiac inoculation of human lung cancer-derived (HARA-B) cells in nude mice, wide range of brain metastases were observed. The brain sections showed significant increase in glial fibrillary acidic protein (GFAP)-positive astrocytes around metastatic lesions. To elucidate the role of astrocytes in lung cancer proliferation, the interaction between primary cultured mouse astrocytes and HARA-B cells was analyzed in vitro. Co-cultures and insert-cultures demonstrated that astrocytes were activated by tumor cell-oriented factors; macrophage migration inhibitory factor (MIF), interleukin-8 (IL-8) and plasminogen activator inhibitor-1 (PAI-1). Activated astrocytes produced interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and interleukin-1 β (IL-1β), which in turn promoted tumor cell proliferation. Semi-quantitative immunocytochemistry showed that increased expression of receptors for IL-6 and its subunits gp130 on HARA-B cells. Receptors for TNF-α and IL-1β were also detected on HARA-B cells but down-regulated after co-culture with astrocytes. Insert-culture with astrocytes also stimulated the proliferation of other lung cancer-derived cell lines (PC-9, QG56, and EBC-1). These results suggest that tumor cells and astrocytes stimulate each other and these mutual relationships may be important to understand how lung cancer cells metastasize and develop in the brain.