title: A multi-analyte serum test for the detection of non-small cell lung cancer.
abstract: BACKGROUND
  In this study, we appraised a wide assortment of biomarkers previously shown to have diagnostic or prognostic value for non-small cell lung cancer (NSCLC) with the intent of establishing a multi-analyte serum test capable of identifying patients with lung cancer.
  
  
  METHODS
  Circulating levels of 47 biomarkers were evaluated against patient cohorts consisting of 90 NSCLC and 43 non-cancer controls using commercial immunoassays. Multivariate statistical methods were used on all biomarkers achieving statistical relevance to define an optimised panel of diagnostic biomarkers for NSCLC. The resulting biomarkers were fashioned into a classification algorithm and validated against serum from a second patient cohort.
  
  
  RESULTS
  A total of 14 analytes achieved statistical relevance upon evaluation. Multivariate statistical methods then identified a panel of six biomarkers (tumour necrosis factor-α, CYFRA 21-1, interleukin-1ra, matrix metalloproteinase-2, monocyte chemotactic protein-1 and sE-selectin) as being the most efficacious for diagnosing early stage NSCLC. When tested against a second patient cohort, the panel successfully classified 75 of 88 patients.
  
  
  CONCLUSIONS
  Here, we report the development of a serum algorithm with high specificity for classifying patients with NSCLC against cohorts of various 'high-risk' individuals. A high rate of false positives was observed within the cohort in which patients had non-neoplastic lung nodules, possibly as a consequence of the inflammatory nature of these conditions.
authors.affiliation: Department of General Surgery, Rush University Medical Center, 785 Jelke-Southcenter, 1750 W. Harrison Street, Chicago, IL 60612, USA.
authors.forename: E C
authors.initials: EC
authors.lastname: Farlow
authors.forename: M S
authors.initials: MS
authors.lastname: Vercillo
authors.forename: J S
authors.initials: JS
authors.lastname: Coon
authors.forename: S
authors.initials: S
authors.lastname: Basu
authors.forename: A W
authors.initials: AW
authors.lastname: Kim
authors.forename: L P
authors.initials: LP
authors.lastname: Faber
authors.forename: W H
authors.initials: WH
authors.lastname: Warren
authors.forename: P
authors.initials: P
authors.lastname: Bonomi
authors.forename: M J
authors.initials: MJ
authors.lastname: Liptay
authors.forename: J A
authors.initials: JA
authors.lastname: Borgia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood; D001774:Blood Chemical Analysis / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000175:diagnosis*; D016022:Case-Control Studies; D015331:Cohort Studies; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D044967:Serum / Q000737:chemistry
chemical_list: D014408:Biomarkers, Tumor