title: Gene expression profiles in peripheral blood mononuclear cells can distinguish patients with non-small cell lung cancer from patients with nonmalignant lung disease.
abstract: Early diagnosis of lung cancer followed by surgery presently is the most effective treatment for non-small cell lung cancer (NSCLC). An accurate, minimally invasive test that could detect early disease would permit timely intervention and potentially reduce mortality. Recent studies have shown that the peripheral blood can carry information related to the presence of disease, including prognostic information and information on therapeutic response. We have analyzed gene expression in peripheral blood mononuclear cell samples including 137 patients with NSCLC tumors and 91 patient controls with nonmalignant lung conditions, including histologically diagnosed benign nodules. Subjects were primarily smokers and former smokers. We have identified a 29-gene signature that separates these two patient classes with 86% accuracy (91% sensitivity, 80% specificity). Accuracy in an independent validation set, including samples from a new location, was 78% (sensitivity of 76% and specificity of 82%). An analysis of this NSCLC gene signature in 18 NSCLCs taken presurgery, with matched samples from 2 to 5 months postsurgery, showed that in 78% of cases, the signature was reduced postsurgery and disappeared entirely in 33%. Our results show the feasibility of using peripheral blood gene expression signatures to identify early-stage NSCLC in at-risk populations.
authors: The Wistar Institute, 3601 Spruce Street, Philadelphia, PA 19104, USA.
authors: Michael K
authors: MK
authors: Showe
authors: Anil
authors: A
authors: Vachani
authors: Andrew V
authors: AV
authors: Kossenkov
authors: Malik
authors: M
authors: Yousef
authors: Calen
authors: C
authors: Nichols
authors: Elena V
authors: EV
authors: Nikonova
authors: Celia
authors: C
authors: Chang
authors: John
authors: J
authors: Kucharczuk
authors: Bao
authors: B
authors: Tran
authors: Elliot
authors: E
authors: Wakeam
authors: Ting An
authors: TA
authors: Yie
authors: David
authors: D
authors: Speicher
authors: William N
authors: WN
authors: Rom
authors: Steven
authors: S
authors: Albelda
authors: Louise C
authors: LC
authors: Showe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D003937:Diagnosis, Differential; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000276:immunology / Q000378:metabolism / Q000502:physiology*; D008171:Lung Diseases / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects