State Key Laboratory of Oncology in Southern China, Collaborative Innovation Centre for Cancer Medicine, and Department of Thoracic Surgery, Sun Yat-Sen University Cancer Centre, Guangzhou, China; Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.
Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.
J Thorac Cardiovasc Surg. 2018 Dec;156(6):2310-2318.e2. doi: 10.1016/j.jtcvs.2018.07.054. Epub 2018 Aug 2.
Sublobar resection may be insufficient for early-stage lung adenocarcinoma with micropapillary or solid components because of the associated higher incidence of locoregional recurrence. This study sought to establish a novel method for rapidly identifying their presence to facilitate decision making for sublobar resection.
Antibody arrays of adhesion and apoptosis molecules were applied for adenocarcinomas with or without micropapillary/solid components to identify differentially expressed proteins. A semi-dry dot-blot system that visualizes the presence of target proteins was used to determine the presence of micropapillary or solid components in a prospective cohort of patients with clinical stage I who underwent operation. Sensitivity and specificity were calculated by comparing semi-dry dot-blot results with pathologic examinations.
Insulin-like growth factor-binding protein 2 and P-cadherin were found more frequently in the micropapillary or solid positive group, and these were used as the target proteins in the semi-dry dot-blot system for detection of micropapillary or solid components. A total of 68 nodules with a mean size of 2.3 ± 0.7 cm, including 13 (19.1%) with a micropapillary and 20 (29.4%) with a solid pattern, were recruited. Micropapillary or solid (+) lesions were more likely to have lymph node upstaging, greater diameter, and higher maximum standardized uptake value. The specificity and sensitivity for detecting the minor presence of micropapillary or solid component using the semi-dry dot-blot method were 94.4% (95% confidence interval, 81.3-99.3) and 65.6% (95% confidence interval, 46.8-81.4), respectively. The average test duration was 26.9 ± 2.5 minutes.
Detecting insulin-like growth factor-binding protein 2 and P-cadherin via the semi-dry dot-blot method could identify micropapillary or solid components in early-stage lung adenocarcinoma in a short processing time.
由于微乳头或实体成分的早期肺腺癌局部复发率较高，肺段切除术可能不充分。本研究旨在建立一种快速识别其存在的新方法，以方便肺段切除术的决策。
采用粘附和凋亡分子抗体阵列对有无微乳头/实体成分的腺癌进行检测，以鉴定差异表达蛋白。应用半干点印迹系统检测靶蛋白的存在，以确定行手术治疗的Ⅰ期临床患者中是否存在微乳头或实体成分。通过比较半干点印迹结果与病理检查结果计算敏感性和特异性。
胰岛素样生长因子结合蛋白 2 和 P-钙黏蛋白在微乳头或实体阳性组中更为常见，因此将其作为半干点印迹系统检测微乳头或实体成分的靶蛋白。共招募了 68 个平均直径为 2.3±0.7cm 的结节，其中 13 个（19.1%）为微乳头型，20 个（29.4%）为实体型。微乳头或实体（+）病变更有可能发生淋巴结升级、更大的直径和更高的最大标准化摄取值。半干点印迹法检测微乳头或实体成分微量存在的特异性和敏感性分别为 94.4%（95%置信区间，81.3-99.3）和 65.6%（95%置信区间，46.8-81.4）。平均检测时间为 26.9±2.5 分钟。
通过半干点印迹法检测胰岛素样生长因子结合蛋白 2 和 P-钙黏蛋白，可以在短时间内识别早期肺腺癌中的微乳头或实体成分。
