Airway epithelial gene expression in the diagnostic evaluation of smokers with suspect lung cancer

Spira, A; Beane, JE; Shah, V; Steiling, K; Liu, G; Schembri, F; Gilman, S; Dumas, YM; Calner, P; Sebastiani, P; Sridhar, S; Beamis, J; Lamb, C; Anderson, T; Gerry, N; Keane, J; Lenburg, ME; Brody, JS

HERO ID

2473970

Reference Type

Journal Article

Year

2007

Language

English

PMID

17334370

HERO ID 2473970
In Press No
Year 2007
Title Airway epithelial gene expression in the diagnostic evaluation of smokers with suspect lung cancer
Authors Spira, A; Beane, JE; Shah, V; Steiling, K; Liu, G; Schembri, F; Gilman, S; Dumas, YM; Calner, P; Sebastiani, P; Sridhar, S; Beamis, J; Lamb, C; Anderson, T; Gerry, N; Keane, J; Lenburg, ME; Brody, JS
Journal Nature Medicine
Volume 13
Issue 3
Page Numbers 361-366
Abstract Lung cancer is the leading cause of death from cancer in the US and the world. The high mortality rate (80-85% within 5 years) results, in part, from a lack of effective tools to diagnose the disease at an early stage. Given that cigarette smoke creates a field of injury throughout the airway, we sought to determine if gene expression in histologically normal large-airway epithelial cells obtained at bronchoscopy from smokers with suspicion of lung cancer could be used as a lung cancer biomarker. Using a training set (n = 77) and gene-expression profiles from Affymetrix HG-U133A microarrays, we identified an 80-gene biomarker that distinguishes smokers with and without lung cancer. We tested the biomarker on an independent test set (n = 52), with an accuracy of 83% (80% sensitive, 84% specific), and on an additional validation set independently obtained from five medical centers (n = 35). Our biomarker had approximately 90% sensitivity for stage 1 cancer across all subjects. Combining cytopathology of lower airway cells obtained at bronchoscopy with the biomarker yielded 95% sensitivity and a 95% negative predictive value. These findings indicate that gene expression in cytologically normal large-airway epithelial cells can serve as a lung cancer biomarker, potentially owing to a cancer-specific airway-wide response to cigarette smoke.
Doi 10.1038/nm1556
Pmid 17334370
Is Certified Translation No
Dupe Override No
Is Public Yes
Language Text English