Increased lung cancer risk in patients with interstitial lung disease and elevated <scp>CEA</scp> and <scp>CA</scp>125 serum tumour markers

Dai, Huaping; Liu, Jianqun; Liang, Lirong; Ban, Chiaki; Jiang, Jing; Liu, Yan; Ye, Qiao; Wang, Chen

doi:10.1111/resp.12317

Cited by 43 publications

(34 citation statements)

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“…This, however, can occur without tumor cells entering circulation [16, 17]. The recognition that tumor cells do enter circulation led to the logical conclusion that all molecular events occurring in solid tumor cells might be reflected in circulation [18–22].…”

Section: Introductionmentioning

confidence: 99%

Circulating mutational portrait of cancer: manifestation of aggressive clonal events in both early and late stages

et al. 2017

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BackgroundSolid tumors residing in tissues and organs leave footprints in circulation through circulating tumor cells (CTCs) and circulating tumor DNAs (ctDNA). Characterization of the ctDNA portraits and comparison with tumor DNA mutational portraits may reveal clinically actionable information on solid tumors that is traditionally achieved through more invasive approaches.MethodsWe isolated ctDNAs from plasma of patients of 103 lung cancer and 74 other solid tumors of different tissue origins. Deep sequencing using the Guardant360 test was performed to identify mutations in 73 clinically actionable genes, and the results were associated with clinical characteristics of the patient. The mutation profiles of 37 lung cancer cases with paired ctDNA and tumor genomic DNA sequencing were used to evaluate clonal representation of tumor in circulation. Five lung cancer cases with longitudinal ctDNA sampling were monitored for cancer progression or response to treatments.ResultsMutations in TP53, EGFR, and KRAS genes are most prevalent in our cohort. Mutation rates of ctDNA are similar in early (I and II) and late stage (III and IV) cancers. Mutation in DNA repair genes BRCA1, BRCA2, and ATM are found in 18.1% (32/177) of cases. Patients with higher mutation rates had significantly higher mortality rates. Lung cancer of never smokers exhibited significantly higher ctDNA mutation rates as well as higher EGFR and ERBB2 mutations than ever smokers. Comparative analysis of ctDNA and tumor DNA mutation data from the same patients showed that key driver mutations could be detected in plasma even when they were present at a minor clonal population in the tumor. Mutations of key genes found in the tumor tissue could remain in circulation even after frontline radiotherapy and chemotherapy suggesting these mutations represented resistance mechanisms. Longitudinal sampling of five lung cancer cases showed distinct changes in ctDNA mutation portraits that are consistent with cancer progression or response to EGFR drug treatment.ConclusionsThis study demonstrates that ctDNA mutation rates in the key tumor-associated genes are clinical parameters relevant to smoking status and mortality. Mutations in ctDNA may serve as an early detection tool for cancer. This study quantitatively confirms the hypothesis that ctDNAs in circulation is the result of dissemination of aggressive tumor clones and survival of resistant clones. This study supports the use of ctDNA profiling as a less-invasive approach to monitor cancer progression and selection of appropriate drugs during cancer evolution.Electronic supplementary materialThe online version of this article (doi:10.1186/s13045-017-0468-1) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Circulating mutational portrait of cancer: manifestation of aggressive clonal events in both early and late stages

et al. 2017

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“…The database of the Beijing Institute of Respiratory Medicine Interstitial Lung Disease Group, Beijing Chao‐Yang Hospital, Capital Medical University (Beijing, China) was used to extract data of MPA patients with IP and IPF patients. IP was defined and classified according to the guideline of IPF and the American Thoracic Society (ATS) and the European Respiratory Society (ERS) Consensus Classification of IIP, as previously described . MPA was diagnosed according to the 1994 Chapel Hill Consensus Conference Nomenclature of Vasculitis and its 2012 revised version .…”

Section: Methodsmentioning

confidence: 99%

Clinical features and prognosis of microscopic polyangiitis with usual interstitial pneumonia compared with idiopathic pulmonary fibrosis

Zhao

Dai

Liu

et al. 2019

Clinical Respiratory J

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Introduction Pulmonary involvement in microscopic polyangiitis (MPA) is common, little is known about the clinical features of MPA with interstitial pneumonia (MPA‐IP). Objectives This study aimed to explore the prevalence of microscopic polyangiitis associated usual interstitial pneumonia (UIP)(MPA‐UIP) and compare its clinical features and prognosis with those of MPA‐non‐UIP and idiopathic pulmonary fibrosis (IPF). Methods A total of 73 patients with MPA‐IP were identified and divided into MPA‐UIP patients and MPA‐non‐UIP patients. The clinical characteristics and survival of MPA‐UIP patients were analysed and compared with those of MPA‐non‐UIP patients and 68 patients with IPF. Results The results showed that 34/73 (47%) MPA‐IP patients were classified as MPA‐UIP patients. Compared with MPA‐non‐UIP patients, MPA‐UIP patients tend to have longer duration of symptoms prior to diagnosis and usually have pulmonary involvement as the initial presentation. However, they were less likely to have proteinuria and/or hematuria. Compared with IPF patients, MPA‐UIP patients usually had multisystem damage, positive anti‐neutrophil cytoplasmic autoantibodies and elevated levels of nonspecific inflammatory markers. MPA‐UIP death was concentrated mainly in the first 3 months after diagnosis and resulted in a higher early mortality compared with IPF. Conclusion UIP is the most frequent type of MPA‐IP. These patients tend to have longer duration of symptoms prior to diagnosis and usually have pulmonary involvement as the first presentation. However, they are less likely to have proteinuria and/or hematuria. MPA patients with UIP can be differentiated from IPF patients through comprehensive analysis of clinical and laboratory findings.

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“…In clinical practice, ca125 and ca15-3 are the tumour markers most widely used for the differential diagnosis of lung cancer 16,17 . In a recent report, Ying et al 18 undertook FIGURE 1 Levels of epidermal growth factor (EGF) in bronchoalveolar lavage fluid.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Epidermal Growth Factor, Cancer Antigen 125, and Cancer Antigen 15-3 in Bronchoalveolar Lavage Fluid of Lung Cancer

et al. 2017

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AimIn the present study, we assessed the diagnostic value of epidermal growth factor (egf) and cancer antigens 125 (ca125) and 15-3 (ca15-3) in bronchoalveolar lavage fluid (balf) of lung cancer from 79 enrolled patients with suspected lung cancer.Methods All patients underwent fibrescopic examination, during which balf samples were collected. Levels of egf, ca125, and ca15-3 were determined in balf using commercially available test kits. ResultsThe results showed that levels of egf in balf were significantly higher in patients with lung cancer than in patients with benign diseases (p < 0.01); no significant differences for ca125 (p = 0.67) or ca15-3 (p = 0.43) in balf were observed between the lung cancer patients and the non-cancer control subjects. With a cut-off value of 27.22 pg/mL, egf showed a sensitivity of 63.6% and a specificity of 65.7% in predicting the malignant nature of pulmonary disease. ConclusionsThe study findings suggest that levels of egf are significantly increased in balf from patients with lung cancer than in balf from patients with benign disease. Detection of the level of egf in balf is proposed as a noninvasive test to identify patients at high risk for lung cancer.

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Increased lung cancer risk in patients with interstitial lung disease and elevated CEA and CA125 serum tumour markers

Abstract: Serum CEA and CA125 levels are often elevated in ILD patients. The risk of cancer in ILD is increased with an elevation of serum CEA and CA125 levels. Serum CEA and CA125 levels may be a marker of cancer in ILD patients.

Cited by 43 publications

References 24 publications

Circulating mutational portrait of cancer: manifestation of aggressive clonal events in both early and late stages

Circulating mutational portrait of cancer: manifestation of aggressive clonal events in both early and late stages

Clinical features and prognosis of microscopic polyangiitis with usual interstitial pneumonia compared with idiopathic pulmonary fibrosis

Diagnostic Value of Epidermal Growth Factor, Cancer Antigen 125, and Cancer Antigen 15-3 in Bronchoalveolar Lavage Fluid of Lung Cancer

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