PURPOSE: Analysis of circulating DNA in plasma can provide a useful marker for earlier lung cancer detection. This study was designed to assess the sensitivity and specificity of a quantitative molecular assay of circulating DNA to identify patients with lung cancer and monitor their disease. MATERIALS AND METHODS: The amount of plasma DNA was determined through the use of real-time quantitative polymerase chain reaction (PCR) amplification of the human telomerase reverse transcriptase gene (hTERT) in 100 non-small-cell lung cancer patients and 100 age-, sex-, and smoking-matched controls. Screening performance of the assay was calculated through the receiver operating characteristic (ROC) curve. Odds ratios were calculated using conditional logistic regression analysis. RESULTS: Median concentration of circulating plasma DNA in patients was almost eight times the value detected in controls (24.3 v 3.1 ng/mL). The area under the ROC curve was 0.94 (95% CI, 0.907 to 0.973). Plasma DNA was a strong risk factor for lung cancer; concentrations in the upper tertile were associated with an 85-fold higher risk than were those in the lowest tertile. CONCLUSION: This study shows that higher levels of free circulating DNA can be detected in patients with lung cancer compared with disease-free heavy smokers by a PCR assay, and suggests a new, noninvasive approach for early detection of lung cancer. Levels of plasma DNA could also identify higher-risk individuals for lung cancer screening and chemoprevention trials.
|Titolo:||Quantification of free circulating DNA as a diagnostic marker in lung cancer|
|Parole Chiave:||Sensitivity and Specificity; Odds Ratio; ROC Curve; Telomerase; DNA-Binding Proteins; Humans; Aged; Predictive Value of Tests; DNA, Neoplasm; Polymerase Chain Reaction; Logistic Models; Lung Neoplasms; DNA Primers; Case-Control Studies; Middle Aged; Carcinoma, Non-Small-Cell Lung; Female; Male|
|Settore Scientifico Disciplinare:||Settore MED/36 - Diagnostica per Immagini e Radioterapia|
|Data di pubblicazione:||1-nov-2003|
|Digital Object Identifier (DOI):||10.1200/JCO.2003.02.006|
|Appare nelle tipologie:||01 - Articolo su periodico|