历史性 p87 可诊断临床表现至少 4 年前的肺癌。

IF 4.5 2区 医学 Q1 ONCOLOGY
Cancers Pub Date : 2025-03-12 DOI:10.3390/cancers17060952
Martin Tobi, Daniel Ezekwudo, Yosef Y Tobi, Xiaoqing Zhao, Fadi Antaki, MaryAnn Rambus, Edi Levi, Harvinder Talwar, Benita McVicker
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引用次数: 0

摘要

肺癌仍然是世界上最常见的癌症,尽管有个性化的治疗方案,预后有限。由于假阳性率高,低剂量CT扫描作为早期诊断手段一直令人失望。需要开发其他非侵入性检测手段,以提供及时诊断和预测预后。方法:在对2922例CRC风险增加的患者进行大规模粪便检测的过程中,我们能够确定112例有文献记载的前瞻性诊断为肺癌的患者。采用ELISA和Western blot检测粪便和结肠排出液中p87抗腺瘤抗体(Adnab-9)的反应性。在可能的情况下获得生存数据。结果:在112例肿瘤中,约27.6%为鳞状细胞癌(SSC), 17.9%为腺癌,8%为小细胞癌,6.25%为大细胞癌,3.57%为非小细胞癌(NSCLC), 0.89%为不确定,0.89%为扩散,3.57%为转移,31.25%为无资料。总的来说,49.1%的肺癌患者进行了粪便Adnab-9检测。总体而言,60%的患者检测呈阳性,而38%的患者检测呈阳性,差异有统计学意义(OR2.19 [1.06-4.53];P = 0.045)。致死率较高的癌症检测呈阳性的可能性较小(小细胞肺癌和大细胞肺癌各约8.5%),而更高,SCC为56%,腺癌为25%(非小细胞肺癌为0%)。在较大的组中,检测阳性患者的总生存期较差:检测阳性患者474天,而SCC为844天;检测阳性患者54天,而腺癌为749天。最重要的是,从阳性检测到临床诊断的时间,小细胞癌为2.72年,腺癌为3.13年,非小细胞肺癌为5.07年,SSC为6.07年,大细胞癌为6.24年。在排除的病例中,肺癌被认为是转移的,83.3%的癌症是阳性的。结论:该测试的实际敏感性为0.60,特异性为0.60,总体上可提前4.7年诊断,可以帮助指导肺癌筛查。此外,Adnab-9检测选择性地检测出更严重的肿瘤类型(87.5%)和更常见、更有利的表型中预后较差的肿瘤类型,从而使那些从该策略中获益最多的患者的早期诊断成为可能。转移性肺癌也可通过该检查发现,但应通过后续影像学检查确定,因此,不应将其视为主要缺陷。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Historic p87 Is Diagnostic for Lung Cancer Preceding Clinical Presentation by at Least 4 Years.

Lung cancer remains the most common cancer worldwide, with a limited prognosis despite personalized treatment regimens. Low-dose computed tomography (CT) scanning as a means of early diagnosis has been disappointing due to the high false positive rate. Other non-invasive means of testing need to be developed that offer both timely diagnosis and predict prognosis. Methods: In the course of stool testing in large-scale testing of 2922 patients at increased risk of CRC, we were able to ascertain 112 patients documented to have prospectively been diagnosed with lung cancer. Stool and colonic effluents were tested for p87 with anti-adenoma antibody (Adnab-9) reactivity by ELISA and Western blot. Survival data were obtained where available. Results: Of 112 cancers, approximately 27.6% were squamous (SSC), 17.9% were adenocarcinoma, 8% were small, 6.25% were large cell, 3.57% were designated non-small cell cancer (NSCLC), 0.89% were indeterminate, 0.89% were lepidic spread, 3.57% had metastasis, and in 31.25%, data were unavailable. In total, 49.1% of the lung cancer patients had fecal Adnab-9 testing. Overall, 60% had positive testing compared to 38%, which was significant (OR2.19 [1.06-4.53]; p = 0.045). Cancers with higher lethality were less likely to test positive (approximately 8.5% each for both small and large cell lung cancers) and higher, with 56% for SCC and 25% for adenocarcinoma (0% NSCLC). In the larger groups, overall survival was worse in those testing positive: 474 testing positives versus 844 days in SCC and 54 testing positive versus 749 days in adenocarcinoma patients. Most importantly, the time from a positive test to the clinical diagnosis ranged from 2.72 years for small cell, 3.13 for adenocarcinoma, 5.07 for NSCLC, 6.07 for SSC, and 6.24 for large cell cancer. In excluded cases where cancer in the lung was believed to be metastatic, 83.3% of cancers were positive. Conclusions: At a projected real-world sensitivity of 0.60 and specificity of 0.60, and the ability to predate diagnosis by up to 4.7 years overall, this test could help direct lung cancer screening. In addition, the Adnab-9 testing selectively detects worse tumor types (87.5%) and those with worse prognoses amongst the more common, favorable phenotypes, thus making early diagnosis possible in those patients who stand to benefit most from this strategy. Metastatic lung cancer, also detected by the test, should be identified by the follow-up imaging studies and, therefore, would not be considered to be a major pitfall.

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来源期刊
Cancers
Cancers Medicine-Oncology
CiteScore
8.00
自引率
9.60%
发文量
5371
审稿时长
18.07 days
期刊介绍: Cancers (ISSN 2072-6694) is an international, peer-reviewed open access journal on oncology. It publishes reviews, regular research papers and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced.
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