Aiman Alzetani1, Sridhar Rathinam1, Nicholas D. James2, Douglas G. Ward2, Jane Starczynski1, Ashley Martin2, Philip J. Johnson2, Pala B. Rajesh1; 1Heart of England NHS Foundation Trust, Birmingham, United Kingdom; 2Cancer Research UK Institute for Cancer Studies, Birmingham, United Kingdom
Objective: There have been few studies looking at the serum proteome of surgically resectable lung cancer and none have examined the changes that occur after successful removal of the cancer and at later follow up. Surface-Enhanced Laser Desorption/Ionisation Time of Flight Mass Spectrometry (SELDI-TOF-MS) is one of the methods for discovering alterations in proteomic profiles in a variety of cancers. We used this technique in examining proteomic fingerprints of lung cancer and the influence surgery has on them.Methods: The target group were recruited from patients referred with a suspicious lung mass for surgical management. The controls were from matched non-cancer subjects attending hospital for routine blood tests and from any patients from the target group who were found to have non-malignant pathology at the time of surgery. This subgroup was classified as sham controls. Serum samples were collected from patients prior to surgery and from the controls at enrolment. Further samples were taken from proven lung cancer patients post surgery and at follow-up. Samples were analysed simultaneously using SELDI-TOF-MS. Wilcoxon tests were used for statistical analysis.
Results: Between January 2005 -September 2006, 70 patients (66% male, average age 65.5 ±10.0 SD) and 75 control subjects (67% male, average age 62.7±12.5 SD, 26 sham controls) were recruited. 14 patients were followed up for an average of 3 months post surgery. 131 peaks were picked on the SELDI analysis from which 40 showed significant differences between cancer patients and controls (p< 0.01). In patients who were followed up and had no evidence of recurrence at 3 months there was a return to a near "normal" profile similar to the controls.
Conclusion: We have demonstrated the presence of a characteristic proteomic profile in the serum of patients with lung cancer that distinguishes them from non-cancer controls. Some of these features disappear after successful resective surgery in patients who have been followed up and had no clinical evidence of incomplete or recurrent disease. These peaks may be targets for further investigations as tumour specific markers while the persistent features may represent a host response to the exposure to cancer and can be used as potential screening tools.
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