title: Rapid Diagnosis of Lung Tumors, a Feasability Study Using Maldi-Tof Mass Spectrometry.
abstract: Despite recent advances in imaging and core or endoscopic biopsies, a percentage of patients have a major lung resection without diagnosis. We aimed to assess the feasibility of a rapid tissue preparation/analysis to discriminate cancerous from non-cancerous lung tissue.
  
  
  
  Fresh sample preparations were analyzed with the Microflex LTTM MALDI-TOF analyzer. Each main reference spectra (MSP) was consecutively included in a database. After definitive pathological diagnosis, each MSP was labeled as either cancerous or non-cancerous (normal, inflammatory, infectious nodules). A strategy was constructed based on the number of concordant responses of a mass spectrometry scoring algorithm. A 3-step evaluation included an internal and blind validation of a preliminary database (n = 182 reference spectra from the 100 first patients), followed by validation on a whole cohort database (n = 300 reference spectra from 159 patients). Diagnostic performance indicators were calculated.
  
  
  
  127 cancerous and 173 non-cancerous samples (144 peripheral biopsies and 29 inflammatory or infectious lesions) were processed within 30 minutes after biopsy sampling. At the most discriminatory level, the samples were correctly classified with a sensitivity, specificity and global accuracy of 92.1%, 97.1% and 95%, respectively.
  
  
  
  The feasibility of rapid MALDI-TOF analysis, coupled with a very simple lung preparation procedure, appears promising and should be tested in several surgical settings where rapid on-site evaluation of abnormal tissue is required. In the operating room, it appears promising in case of tumors with an uncertain preoperative diagnosis and should be tested as a complementary approach to frozen-biopsy analysis.
authors.affiliation: Service de chirurgie thoracique et des maladies de l'œsophage, Pôle cardio-vasculaire et thoracique, Centre Hospitalo-Universitaire Nord, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, Marseille, France.|Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, URMITE CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Faculté de Médecine, Aix-Marseille Université, Marseille, France.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Brioude
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, URMITE CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Faculté de Médecine, Aix-Marseille Université, Marseille, France.|Service desExplorations Fonctionnelles Respiratoires Centre Hospitalo-Universitaire Nord, Pôle cardio-vasculaire et thoracique, Assistance Publique Hôpitaux de Marseille, Marseille, France.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Brégeon
authors.affiliation: Service de chirurgie thoracique et des maladies de l'œsophage, Pôle cardio-vasculaire et thoracique, Centre Hospitalo-Universitaire Nord, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, Marseille, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Trousse
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, URMITE CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Faculté de Médecine, Aix-Marseille Université, Marseille, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Flaudrops
authors.affiliation: Service d'anatomie pathologique, hôpital Nord, Aix Marseille université, Marseille, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Secq
authors.affiliation: Service de chirurgie thoracique et des maladies de l'œsophage, Pôle cardio-vasculaire et thoracique, Centre Hospitalo-Universitaire Nord, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, Marseille, France.
authors.forename: Florence
authors.initials: F
authors.lastname: De Dominicis
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, URMITE CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Faculté de Médecine, Aix-Marseille Université, Marseille, France.|Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie,Centre Hospitalo-Universitaire Timone, Assistance publique des hôpitaux de Marseille, Marseille, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Chabrières
authors.affiliation: Service de chirurgie thoracique et des maladies de l'œsophage, Pôle cardio-vasculaire et thoracique, Centre Hospitalo-Universitaire Nord, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, Marseille, France.|Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, URMITE CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Faculté de Médecine, Aix-Marseille Université, Marseille, France.
authors.forename: Xavier-Benoit
authors.initials: XB
authors.lastname: D'journo
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, URMITE CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Faculté de Médecine, Aix-Marseille Université, Marseille, France.|Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Fédération de Bactériologie-Hygiène-Virologie,Centre Hospitalo-Universitaire Timone, Assistance publique des hôpitaux de Marseille, Marseille, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
authors.affiliation: Service de chirurgie thoracique et des maladies de l'œsophage, Pôle cardio-vasculaire et thoracique, Centre Hospitalo-Universitaire Nord, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, Marseille, France.|Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, URMITE CNRS 7278 IRD 198 INSERM U1905, IHU Méditerranée Infection, Faculté de Médecine, Aix-Marseille Université, Marseille, France.
authors.forename: Pascal-Alexandre
authors.initials: PA
authors.lastname: Thomas
mesh_terms: D000368:Aged; D001706:Biopsy; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*; D013997:Time Factors