Thoracic Oncology Laboratory, Department of Cardiothoracic Surgery, NYU School of Medicine, New York, NY 10016, USA.
Cancer Biomark. 2012;12(4):177-84. doi: 10.3233/CBM-130306.
As CT screening is integrated into non-small cell lung cancer (NSCLC) care, additional parameters are needed to help distinguish cancers from benign nodules. Osteopontin (OPN), a secreted phosphoprotein, has elevated plasma levels in NSCLC. We hypothesize that changes in plasma OPN over time (i.e., OPN velocity [OPNV]) can differentiate NSCLC patients from those without cancer in a CT screening population.
A nested case-control study was conducted within a NSCLC CT screening trial. Incident cancers with serial plasma were matched to controls. OPN was measured by ELISA. Demographic, OPN, and OPNV were compared between cancers and controls using Wilcoxon Signed Rank tests.
Ten incident cancers were identified. The pack years distributions were similar, but cancers were older (median of the paired difference: 5.35 years; p=0.002) and their surveillance intervals were shorter (median of the paired difference: -2 months; p=0. 03) than matched controls. Baseline OPN was similar (median of the paired difference: -5.15 ng/ml, p=0.50), but OPNV in the cancers was significantly greater than that of matched controls, (median of the paired difference: 1.06 ng/ml/month, p=0.01). Accuracy rate for prediction of disease status based on OPNV (adjusted for age and surveillance) was 83%.
These are early evidence for utility of monitoring plasma OPN during CT screening to assist in identification of NSCLCs.
随着 CT 筛查被纳入非小细胞肺癌（NSCLC）的治疗中，需要额外的参数来帮助区分癌症和良性结节。骨桥蛋白（OPN）是一种分泌型磷酸蛋白，在 NSCLC 患者的血浆中水平升高。我们假设，在 CT 筛查人群中，OPN 随时间的变化（即 OPN 速度[OPNV]）可以帮助区分 NSCLC 患者和无癌症患者。
在一项 NSCLC CT 筛查试验中进行了一项嵌套病例对照研究。对具有连续血浆的新发癌症与对照进行匹配。通过 ELISA 测量 OPN。使用 Wilcoxon 符号秩检验比较癌症与对照之间的人口统计学、OPN 和 OPNV。
发现了 10 例新发癌症。两组的吸烟年分布相似，但癌症患者年龄更大（配对差异中位数：5.35 岁；p=0.002），监测间隔更短（配对差异中位数：-2 个月；p=0.03）。基线 OPN 相似（配对差异中位数：-5.15ng/ml，p=0.50），但癌症患者的 OPNV 明显高于匹配对照（配对差异中位数：1.06ng/ml/月，p=0.01）。基于 OPNV（调整年龄和监测）预测疾病状态的准确率为 83%。
这些早期证据表明，在 CT 筛查期间监测血浆 OPN 有助于识别 NSCLC。
