title: Serum free fatty acid biomarkers of lung cancer.
abstract: BACKGROUND
  Lung cancer is the leading cause of cancer-related mortality. Surgical removal of the tumor at an early stage can be curative. However, lung cancer diagnosis at an early stage remains challenging. There is evidence that free fatty acids play a role in cancer development.
  
  
  METHODS
  Serum samples from 55 patients with lung cancer were propensity matched with samples from 165 similar pulmonary patients without known cancer. Patients were propensity matched on age, sex, smoking history, family history of lung cancer, and chronic diseases that might affect free fatty acid levels.
  
  
  RESULTS
  Free fatty acids arachidonic acid (AA) and linoleic acid (LA) and their metabolites hydroxyeicosatetraenoic acids (HETEs)(5-HETE, 11-HETE, 12-HETE, and 15-HETE) were an estimated 1.8- to 3.3-fold greater in 37 patients with adenocarcinoma vs 111 patients without cancer (all P < .001). Areas under the receiver operating characteristic curve were significantly > 0.50, discriminating patients with lung cancer and control subjects for six of eight biomarkers and two of seven phospholipids tested, and ranged between 0.69 and 0.82 (all P < .001) for patients with lung cancer vs control subjects. AA, LA, and 15-HETE had observed sensitivity and specificity > 0.70 at the best cutpoint. Concentrations of free fatty acids and their metabolites were similar in 18 patients with squamous cell carcinoma and 54 control subjects without cancer.
  
  
  CONCLUSIONS
  Serum fatty acids and their metabolites demonstrate good sensitivity and specificity for the identification of adenocarcinoma of the lung.
authors.affiliation: Department of Outcomes Research, Department of Pulmonary, Allergy, Cleveland Clinic, Cleveland, OH; Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, OH.
authors.forename: Jinbo
authors.initials: J
authors.lastname: Liu
authors.affiliation: Critical Care Medicine, Cleveland Clinic, Cleveland, OH.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Mazzone
authors.affiliation: Department of Outcomes Research, Department of Pulmonary, Allergy, Cleveland Clinic, Cleveland, OH; Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Cata
authors.affiliation: Department of Outcomes Research, Department of Pulmonary, Allergy, Cleveland Clinic, Cleveland, OH.
authors.forename: Andrea
authors.initials: A
authors.lastname: Kurz
authors.affiliation: Department of Outcomes Research, Department of Pulmonary, Allergy, Cleveland Clinic, Cleveland, OH.
authors.forename: Maria
authors.initials: M
authors.lastname: Bauer
authors.affiliation: Department of Outcomes Research, Department of Pulmonary, Allergy, Cleveland Clinic, Cleveland, OH; Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Mascha
authors.affiliation: Department of Outcomes Research, Department of Pulmonary, Allergy, Cleveland Clinic, Cleveland, OH. Electronic address: DS@OR.org.
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Sessler
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005231:Fatty Acids, Unsaturated / Q000097:blood; D005260:Female; D006801:Humans; D006893:Hydroxyeicosatetraenoic Acids / Q000097:blood; D019787:Linoleic Acid / Q000097:blood; D008175:Lung Neoplasms / Q000097:blood* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000097:blood; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D005230:Fatty Acids, Nonesterified; D005231:Fatty Acids, Unsaturated; D006893:Hydroxyeicosatetraenoic Acids; D010743:Phospholipids; C495366:hydroxyoctadecadienoic acid; D019787:Linoleic Acid