Clinical evaluation of serum tumour marker CA 242 in non-small cell lung cancer

Spatially-resolved dual-potential sandwich electrochemiluminescence immunosensor for the simultaneous determination of carbohydrate antigen 19-9 and carbohydrate antigen 24-2

A new electrochemiluminescence (ECL) immunosensor based on spatially-resolved dual-potential technology was designed for the simultaneous determination of carbohydrate antigen 19-9 (CA 19-9) and carbohydrate antigen 24-2 (CA 242). Luminol-AgNPs@ZIF-67 was used as the anodic probe, and Pt nanoparticle-functionalized graphitic carbon nitride nanosheets (g-C₃N₄@PtNPs) were used as the cathodic probe. Two spatially-resolved areas on the dual-disk glassy carbon electrode (DDGCE) were modified with a AuNPs film by electrodeposition to improve the conductivity of the sensing interface. By recording the ECL responses at two different excitation potentials, the linear range for CA 19-9 was determined to be 0.0001-10 U/mL, with a limit of detection of 31 μU/mL. The linear range for CA 242 was 0.0005-10 U/mL, with a limit of detection of 0.16 mU/mL. Moreover, the ECL immunosensor possessed high selectivity and stability and successfully detected CA 19-9 and CA 242 in real samples. This immunosensor provides a new platform for clinical immunoassays.

Comprehensive analysis of genomic alterations detected by next-generation sequencing-based tissue and circulating tumor DNA assays in Chinese patients with non-small cell lung cancer

While tumor genotyping is the standard treatment for patients with non-small cell lung cancer (NSCLC), spatial and temporal tumor heterogeneity and insufficient specimens can lead to limitations in the use of tissue-based sequencing. Circulating tumor DNA (ctDNA) fully encompasses tumor-specific sequence alterations and offers an alternative to tissue sample biopsies. However, few studies have evaluated whether the frequency of multiple genomic alterations observed following ctDNA sequencing is similar to that observed following tissue sequencing in NSCLC. Therefore, in the present study, targeted next-generation sequencing (NGS) was performed on tissue and plasma ctDNA samples in 99 patients with NSCLC. Overall, the frequencies of genetic alterations detected in ctDNA were positively correlated with those detected via tissue profiling (r=0.812; P=0.022). Genomic data revealed significant mutual exclusivity between alterations in epidermal growth factor receptor (EGFR) and tumor protein 53 (TP53; P=0.020), and between alterations in EGFR and KRAS (P=0.008), as well as potential mutual exclusivity between alterations in EGFR and Erb-B2 receptor tyrosine kinase 2 (P=0.059). Furthermore, the EGFR mutant allele frequency (MAF) was positively correlated with the TP53 MAF in individual tumors (r=0.773; P=0.005), and there was a marked difference in the EGFR MAF between patients with and without the TP53 mutation (P=0.001). Levels of the tumor serum marker CA242 in patients with ctDNA-detectable mutations were higher compared with those in patients without ctDNA-detectable mutations. The data from the present study highlight the importance of tissue and plasma ctDNA screening by NGS to guide personalized therapy and promote the clinical management of patients with NSCLC.

Multifunctionalized ZIFs nanoprobe-initiated tandem reaction for signal amplified electrochemical immunoassay of carbohydrate antigen 24-2

Based on multifunctionalized zeolitic imidazolate frameworks (ZIFs)-initiated cascade reaction triggered signal amplification strategy, a novel sandwich-type amperometric immunosensor was constructed for ultrasensitive detection of carbohydrate antigen 24-2 (CA 242). The methylene blue-glucose oxidase-ZIF-8/reduced graphene oxide-Au (MB-GOx-ZIF-8/Au-rGO) was synthesized by a facile coprecipitation method for enzyme immobilization and redox species loading. The multifunctionalized ZIFs conjugated with labeling antibodies were employed as immunoprobe. In the presence of glucose, tandem reaction was driven by the immunoprobe to catalyze the glucose oxidation to yield H₂O₂. Simultaneously, the generated H₂O₂ induced the decomposition of poly(anilineboronicacid) (PABA)/poly(vinyl alcohol) (PVA) films on substrate, which made the PVA chains breaking away from PABA polymer. Due to the poor conductivity of PVA chains, this decomposition reaction can amplify the current signal. The current difference (ΔI) caused by per unit concentration target with tandem reaction amplification was elevated prominently, resulting in ultrasensitive analytical performance of the immunosensor. Under optimal conditions, the proposed immunosensor displayed wide linear range from 0.001 to 1000 U mL^-1 with an ultralow limit of detection 69.34 μU mL^-1 (S/N = 3). This method successfully implemented functionalized ZIFs in immunoprobe construction for sensitivity amplification, providing a promising strategy to construct ultrasensitive immunosensing platform for analysis of other tumor marker.

Prognostic factors

The best predictive models of today can predict no more than 50% of the natural variability of the disease, despite the sophisticated mathematic analyses and the dozens of variables assessed. Clearly, a universe of still unknown prognostic factors remains to be discovered. Analogous to infinity being immeasurable, the fate of the individual patient will never be calculated mathematically. As the discovery of new prognostic factors continues, however, the prediction of the outcome of patients becomes more reliable. Although some prognostic factors (eg, tumor neoangiogenesis and quality of life) are already supported by a large body of evidence, recent research has introduced new groups of prognostic factors (eg, molecular genetic markers and the subclinical activation of coagulation fibrinolysis). Other intriguing factors (eg, a state of mental depression) might also be recognized as important in the near future. A new small portion of the universe has been explored.

Recent advances in the molecular diagnosis of lung cancer

Despite extensive effort in improvement of diagnosis and treatment of patients with lung cancer in past three decades, the overall survival of patients with the disease remains dismal. Because the development of lung cancer takes a few decades, early diagnosis of the disease or identification of truly high-risk populations may provide us opportunity to successfully cure or prevent the disease. Recent advances in understanding biological basis of lung tumorigenesis provide new tools for detecting malignant cells or the process of malignant transformation and progression. Along with identification of molecular abnormalities in the early lung tumorigenesis, advanced molecular analytic technologies have been emerged, which may facilitate development of rapid and effective methods for early diagnosis and risk assessment. Here, I discuss recent progresses in understanding of early molecular abnormalities in lung cancer, efforts of translating laboratory findings to clinical tests, and prospective of biomarkers in lung cancer diagnosis and risk assessment.

Clinical aspects of altered glycosylation of glycoproteins in cancer

Alteration of the expression of carbohydrate structures is frequently observed in tumor cells. This review summarizes the different changes of O- and N-linked glycoproteins observed in cancer cells, the impact of the tumor-related carbohydrate phenotypes on the clinical outcome of the cancer disease, and the various ways in which carbohydrate structures can interact with different carbohydrate-detecting adhesion molecules, selectins, and sialoadhesins. Various ways of inhibiting the formation of cell adhesion-engaged carbohydrates on the cell surface, or inhibiting the binding are discussed. Carbohydrate structures which are in clinical use as circulating tumor markers and the effect of genotypes on tumor marker concentrations are reviewed.

Clinical aspects of altered glycosylation of glycoproteins in cancer

Alteration of the expression of carbohydrate structures is frequently observed in tumor cells. This review summarizes the different changes of O- and N-linked glycoproteins observed in cancer cells, the impact of the tumor-related carbohydrate phenotypes on the clinical outcome of the cancer disease, and the various ways in which carbohydrate structures can interact with different carbohydrate-detecting adhesion molecules, selectins, and sialoadhesins. Various ways of inhibiting the formation of cell adhesion-engaged carbohydrates on the cell surface, or inhibiting the binding are discussed. Carbohydrate structures which are in clinical use as circulating tumor markers and the effect of genotypes on tumor marker concentrations are reviewed.

Circulating blood group related carbohydrate antigens as tumour markers

The various blood group related carbohydrate structures which are in clinical use as circulating tumour makers are reviewed. Their location on carbohydrate chains and their structural characteristics are shown, and their clinical performance in various malignant diseases is reviewed. The available data on their sensitivity, specificity and predictive value are shown; and carcinomas of the pancreas, ventricle, colon-rectum and ovary are identified as diseases in which these markers can be of good benefit for follow-up. Future research should be devoted to studies of the function of these structures, and to studies of their gene-transcription.

Clinical evaluation of serum tissue polypeptide-specific antigen (TPS) in non-small cell lung cancer

M3 is an epitope of the tissue polypeptide antigen detectable in the serum by immunoradiometric assay. This epitope is referred to as tissue polypeptide-specific antigen (TPS). We examined the pretreatment TPS level of 160 non-small cell lung cancer (NSCLC) patients and 71 patients who suffered from non-malignant pulmonary diseases. The upper limit of normal values was 140 U/l. Using this cutoff, the sensitivity and specificity were 36 and 90%, respectively. The TPS was significantly higher in NSCLC patients with an advanced stage, a mediastinal lymph node involvement or a poor performance status. This level was significantly higher in the group of patients for whom the disease proved to progress during chemotherapy. In univariate analysis, patients with a high TPS level proved to have a shorter survival than patients with a TPS < or = 140 U/l. In Cox's model analysis, performance status, stage of the disease and serum TPS were the only significant prognostic variables. The low sensitivity of TPS precludes its use for diagnosis. However, the pretreatment TPS level adds information to the management of NSCLC inasmuch as it predicts a low sensitivity to chemotherapy and a poor prognosis.