Biomarkers for screening of lung cancer and pre-neoplastic lesions in a high risk Chilean population.
BACKGROUND
The mortality of lung cancer (LC), increases each year in the world, in spite of any advances, in development of new drugs to advance stages of LC. The high incidence of LC has been associated with smoking habit, genetic diversity and environmental pollution. Antofagasta region has been reported to have the highest LC mortality rate in Chile and its inhabitants were exposed to arsenic in their drinking water in concentrations as high as 870 μg/L. Non-invasive techniques such as biomarkers (Automatic Quantitative Cytometry: AQC and DR70) and Auto Fluorescence Bronchoscopy (AFB) might be potentially useful as a supplementary diagnostic approach and early detection. Early detection is one of the most important factors to intervene and prevent cancer progression in LC. This is a work of an ongoing prospective bimodality cancer surveillance study in high risk LC volunteers. Enrolment was done in subjects from Antofagasta and Metropolitan regions. In addition, we enrolled subjects who were suspected of having lung cancer. AQC, DR70 and AFB were used as tools in the detection of pre-neoplastic (PNL) and neoplastic lesions (NL).


RESULTS
Half of the samples, classified as suspicious by AFB, were confirmed as metaplasia or dysplasia by histopathology. For LC, DR70 showed a higher sensitivity (95.8%) and specificity (91.9%) than AQC. However, for PNL AQC showed a higher sensitivity (91.9%) than DR70 (27.3%), although both with low PPV values. As a pre screener, both biomarkers might be employed as complementary tools to detect LC, especially as serially combined tests, with a sensitivity of 60% and a PPV of 65.2%. Additionally, the use of parallel combined tests might support the detection of PNL (sensitivity 91.2%; PPV 49.1%).


CONCLUSIONS
This work adds information on cellular and molecular biomarkers to complement imaging techniques for early detection of LC in Latin America that might contribute to formulate policies concerning screening of LC. Supported by INNOVA-CORFO, Chile.
Faculty of Medicine,Avenida Independencia, University of Chile, Santiago, 1027, Chile. madonis@med.uchile.cl.
Marta I
MI
Adonis
Faculty of Medicine,Avenida Independencia, University of Chile, Santiago, 1027, Chile. jdiazg@med.uchile.
Jose
J
Díaz
Barros Lucos Trudeau Hospital, Santiago, Chile. hasylu@hotmail.com.
Veronica R
VR
Miranda
San Borja Arriaran Hospital, Santiago, Chile. marco_chahuan29@hotmail.com.
Marco
M
Chahuan
Antofagasta Regional Hospital, Antofagasta, Chile. alcidedu@gmail.com.
Alcides
A
Zambrano
Antofagasta Regional Hospital, Antofagasta, Chile. hugocesarpatologo@gmail.co.
Hugo C
HC
Benitez
Barros Lucos Trudeau Hospital, Santiago, Chile. mmcamposm@hotmail.com.
Monica
M
Campos
Faculty of Medicine,Avenida Independencia, University of Chile, Santiago, 1027, Chile. p.avaria@gmail.com.
Pablo
P
Avaria
Faculty of Medicine,Avenida Independencia, University of Chile, Santiago, 1027, Chile. uurzua@med.uchile.cl.
Ulises
U
Urzúa
Antofagasta Regional Hospital, Antofagasta, Chile. pedromarinh@hotmail.com.
Pedro
P
Marín
La Portada Clinic, Antofagasta, Chile. mgohurdett@hotmail.com.
Mariela
M
Gohurdett
La Portada Clinic, Antofagasta, Chile. yasny2@gmail.com.
Yasna
Y
Cisterna
Faculty of Medicine,Avenida Independencia, University of Chile, Santiago, 1027, Chile. lgil@med.uchile.cl.
Lionel
L
Gil
D000230:Adenocarcinoma / Q000453:epidemiology / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000379:methods; D002277:Carcinoma / Q000453:epidemiology / Q000473:pathology; D002677:Chile / Q000453:epidemiology; D016001:Confidence Intervals; D004311:Double-Blind Method; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D019044:Image Cytometry / Q000592:standards; D008175:Lung Neoplasms / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000175:diagnosis; D008875:Middle Aged; D061848:Optical Imaging / Q000592:standards; D011230:Precancerous Conditions / Q000473:pathology*; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D018571:Sentinel Surveillance; D055752:Small Cell Lung Carcinoma / Q000453:epidemiology / Q000473:pathology; D013183:Sputum / Q000166:cytology