Department of Experimental Oncology and Laboratory, National Cancer Institute, Milan, Italy.
Cancer. 2010 Mar 1;116(5):1326-35. doi: 10.1002/cncr.24868.
The authors investigated whether early stage lung cancer could be identified by proteomic analyses of plasma.
For the first case-control study, plasma samples from 52 patients with lung cancer and from a group of 51 controls were analyzed by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. In a second case-control study, a classifier of 4 markers (mass-to-charge ratio, 11,681, 6843, 5607, and 8762) also was tested for validation on plasma from 16 consecutive patients with screen-detected cancer versus 406 healthy individuals. The most relevant marker was identified, and an enzyme-linked immunosorbent assay-based analysis revealed that signal intensity was correlated with concentration.
The classifier had a sensitivity of 94.23% and a specificity of 76.47% in the first study but lost predictive value in the second study. Nevertheless, the 11,681 cluster, which was identified as serum amyloid protein A (SAA), resulted in a multiple logistic regression model that indicated a strong association with lung cancer. When both studies were considered as a together, the odds ratio (OR) for an SAA intensity > or =0.5 was 10.27 (95% confidence interval [CI], 4.64-22.74), whereas an analysis restricted to stage I cancers (TNM classification) revealed an OR of 8.45 (95% CI, 2.76-25.83) for T1 lung cancer and 21.22 (95% CI, 5.62-80.14) for T2 lung cancer.
SAA levels were predictive of an elevated risk of lung cancer, supporting the general view that inflammation is implicated in lung cancer development.
作者研究了通过等离子体的蛋白质组分析是否可以识别早期肺癌。
在第一项病例对照研究中，对 52 例肺癌患者和 51 例对照组的血浆样本进行了表面增强激光解吸/电离飞行时间质谱分析。在第二项病例对照研究中，还对 4 个标志物（质荷比 11681、6843、5607 和 8762）的分类器进行了验证，该分类器在来自 16 例经筛查发现的癌症患者与 406 名健康个体的血浆上进行了测试。鉴定出最相关的标志物，并进行了酶联免疫吸附分析，发现信号强度与浓度相关。
在第一项研究中，分类器的敏感性为 94.23%，特异性为 76.47%，但在第二项研究中失去了预测价值。尽管如此，鉴定出的 11681 簇为血清淀粉样蛋白 A（SAA），这使得建立了一个与肺癌强烈相关的多变量逻辑回归模型。当将两项研究综合考虑时，SAA 强度≥0.5 的比值比（OR）为 10.27（95%置信区间 [CI]，4.64-22.74），而对 I 期癌症（TNM 分类）的分析则表明 T1 期肺癌的 OR 为 8.45（95%CI，2.76-25.83），T2 期肺癌的 OR 为 21.22（95%CI，5.62-80.14）。
SAA 水平可预测肺癌风险升高，这支持了炎症与肺癌发生有关的一般观点。
