Quantification of free circulating DNA as a diagnostic marker in lung cancer
- PMID: 14507943
- DOI: 10.1200/JCO.2003.02.006
Quantification of free circulating DNA as a diagnostic marker in lung cancer
Abstract
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.
Comment in
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Early detection of lung cancer using serum RNA or DNA markers: ready for "prime time" or for validation?J Clin Oncol. 2003 Nov 1;21(21):3891-3. doi: 10.1200/JCO.2003.07.976. Epub 2003 Sep 24. J Clin Oncol. 2003. PMID: 14507944 Review. No abstract available.
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Free circulating DNA: good as a diagnostic marker in lung cancer?J Clin Oncol. 2004 Aug 1;22(15):3201-2; author reply 3202. doi: 10.1200/JCO.2004.99.020. J Clin Oncol. 2004. PMID: 15284278 No abstract available.
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Reproducibility of a semiquantitative measurement of circulating DNA in plasma from neoplastic patients.J Clin Oncol. 2005 May 1;23(13):3163-4; author reply 3164-5. doi: 10.1200/JCO.2005.05.430. J Clin Oncol. 2005. PMID: 15860889 No abstract available.
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