Monitoring non-small cell lung cancer progression and treatment response through hyaluronic acid in sputum

Abstract

We evaluated whether hyaluronan (HA) levels in the sputum could be used as a noninvasive tool to predict progressive disease and treatment response, as detected in a computed tomography scan in non-small cell lung cancer (NSCLC) patients. Sputum samples were collected from 84 patients with histological confirmation of NSCLC, 33 of which were in early-stage and 51 in advanced-stage disease. Patients received systemic chemotherapy (CT) after surgery (n=36), combined CT and immunotherapy (IO) (n=15), or targeted therapy for driver mutation and disease relapse (N=4). The primary end-point was to compare sputum HA levels in two different concentrations of hypertonic saline solution with overall survival (OS) and the secondary and exploratory end-points were radiologic responses to treatment and patient outcome. Higher concentrations of HA in the sputum were significantly associated to factors related to tumor stage, phenotype, response to treatment, and outcome. In the early stage, patients with lower sputum HA levels before treatment achieved a complete tumor response after systemic CT with better progression-free survival (PFS) than those with high HA levels. We also examined the importance of the sputum HA concentration and tumor response in the 51 patients who developed metastatic disease and received CT+IO. Patients with low levels of sputum HA showed a complete tumor response in the computed tomography scan and stable disease after CT+IO treatment, as well as a better PFS than those receiving CT alone. HA levels in sputum of NSCLC patients may serve as a candidate biomarker to detect progressive disease and monitor treatment response in computed tomography scans.

Screening for cytological changes associated with inhaled polluted materials in Khartoum industrial area

“…In several cytological studies, sputum cytology has been considered a valuable and accurate diagnostic tool for assessing lung epithelial cells abnormality (Salih et al, 2017;Fan et al, 2021). Also, it was used in the diagnosis of several cases of bronchogenic carcinoma (Chinoca et al, 2022).…”

Combined Determination of CXCR1, CXCR2, Hyaluronic Acid and CYFRA 21-1 Receptors in the Blood in the Diagnosis of Non-Small Cell Lung Cancer

“…В связи с тем, что рецепторы CXCR1 и CXCR2 являются неотъемлемыми составляющими опухолеассоциированной воспалительной реакции, а ГК участвует в инвазии и метастазировании опухоли, повышение уровня этих соединений в крови пациентов закономерно и ожидаемо. Другими исследователями ранее также были получены данные, свидетельствующие о существенном росте уровня ГК и в мокроте пациентов с раком легкого [13]. Вместе с тем в этих работах не учитывался гистологический подтип заболевания и стадия опухолевого процесса.…”

“…Результаты работ, посвященных измерению концентрации ГК в крови пациентов с НМКРЛ, в литературе также отсутствуют. Наряду с этим сообщается, что уровень указанного показателя повышен в мокроте пациентов с раком легкого безотносительно гистологического подтипа и стадии заболевания [13].…”