Validating Methylated HOXA9 in Bronchial Lavage as a Diagnostic Tool in Patients Suspected of Lung Cancer
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Participants and Study Design
2.2. Definition of Patient Characteristics
2.3. Diagnostic Work-Up
2.4. Bronchoscopy and Bronchial Lavage Sampling
2.5. Reference Test
2.6. Analysis of Methylated HOXA9
2.7. Determining the Optimal Cut-Off for Methylated HOXA9
2.8. Statistical Analysis
3. Results
3.1. Participant Characteristics
3.2. Methylated HOXA9 and Lung Cancer
3.3. Predictive Modelling
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Discovery Cohort Cases (n = 67) | Discovery Cohort Controls (n = 34) | Validation Cohort Cases (n = 50) | Validation Cohort Controls (n = 45) |
---|---|---|---|---|
Basic information | ||||
Age, years | 73 (65–77) | 64 (54–73) | 69 (63–77) | 63 (56–72) |
Sex, male | 39/67 (58%) | 19/34 (56%) | 24/50 (48%) | 26/45 (58%) |
Employment status, employed | 5/65 (8%) | 11/29 (38%) | 10/47 (21%) | 21/39 (54%) |
Smoking status: | ||||
Never | 7/67 (10%) | 6/34 (18%) | 2/50 (4%) | 13/45 (29%) |
Ever | 60/67 (90%) | 28/34 (82%) | 48/50 (96%) | 32/45 (71%) |
Pack years | 40 (20–50) | 20 (12–40) | 35 (21–50) | 15 (0–45) |
Performance status: | ||||
0 | 27/67 (40%) | 19/33 (58%) | 34/49 (69%) | 30/42 (71%) |
1 | 27/67 (40%) | 9/33 (27%) | 10/49 (20%) | 10/42 (24%) |
≥2 | 13/67 (19%) | 5/33 (15%) | 5/49 (10%) | 2/42 (5%) |
FEV1, liter | 1.87 (1.24–2.44) | 2.33 (1.52–2.99) | 2.09 (1.54–2.44) | 2.54 (1.95–2.85) |
Comorbidity | ||||
Any comorbidity | 58/67 (87%) | 28/34 (82%) | 43/50 (86%) | 37/45 (82%) |
Cancer within 5 years | 26/67 (39%) | 9/34 (26%) | 5/50 (10%) | 3/45 (7%) |
Previous lung cancer | 24/67 (36%) | 6/34 (18%) | 0/50 (0%) | 0/45 (0%) |
Discovery Cohort | Validation Cohort | |||
---|---|---|---|---|
Variable | Cases (n = 67) | Controls (n = 34) | Cases (n = 50) | Controls (n = 45) |
Tumor on CT scan | 60 | 11 | 50 | 28 |
Largest mean diameter, mm | 27 (19–47) | 19 (13–22) | 42 (23–70) | 22 (14–50) |
Localization | - | - | - | - |
Central | 19/60 (28%) | 3/11 (27%) | 12/50 (24%) | 6/28 (21%) |
Intermediate | 15/60 (22%) | 2/11 (18%) | 22/50 (44%) | 11/28 (39%) |
Peripheral | 26/60 (39%) | 6/11 (55%) | 16/50 (32%) | 11/28 (39%) |
Confirmed lung cancer | ||||
Stage | - | - | - | |
1 | 18/65 (28%) | - | 5/48 (10%) | - |
2 | 7/65 (11%) | - | 14/48 (29%) | - |
3 | 16/65 (25%) | - | 16/48 (33%) | - |
4 | 24/65 (37%) | - | 13/48 (27%) | - |
Histology | - | - | ||
Adenocarcinoma | 32/67 (48%) | - | 34/50 (68%) | - |
Squamous cell carcinoma | 22/67 (33%) | - | 8/50 (16%) | - |
Small cell carcinoma | 6/67 (9%) | - | 3/50 (6%) | - |
Other non-small cell lung cancer | 7/67 (10%) | - | 5/50 (10%) | - |
Discovery Cohort | Validation Cohort | |||||
---|---|---|---|---|---|---|
Diagnosis | HOXA9+ | HOXA9− | Total | HOXA9+ | HOXA9− | Total |
Lung cancer | 49 | 18 | 67 | 40 | 10 | 50 |
No lung cancer | 5 | 29 | 34 | 11 | 34 | 45 |
Total | 54 | 47 | 101 | 51 | 44 | 95 |
Sensitivity (95% CI) | 73.1% (60.9%–83.2%) | 80.0% (66.3%–90.0%) | ||||
Specificity (95% CI) | 85.3% (68.9%–95.0%) | 75.6% (60.5%–87.1%) | ||||
PPV (95% CI) | 90.7% (79.7%–96.9%) | 78.4% (64.7%–88.7%) | ||||
NPV (95% CI) | 61.7% (46.4%–75.5%) | 77.3% (62.2%–88.5%) |
Discovery Cohort | Validation Cohort | |||||
---|---|---|---|---|---|---|
Cases (n = 67) | Controls (n = 34) | Cases (n = 50) | Controls (n = 45) | |||
Variables | OR (95% CI) | OR (95% CI) | p-Value | OR (95% CI) | OR (95% CI) | p-Value |
Age, years | - | - | - | - | - | - |
Crude OR | 1 (ref) | 1.06 (1.02–1.11) | 0.002 * | 1 (ref) | 1.08 (1.03–1.13) | 0.001 * |
Adjusted OR | 1 (ref) | 1.06 (1.01–1.11) | 0.023 * | 1 (ref) | 1.07 (1.01–1.14) | 0.020 * |
Smoking status, ever | - | - | - | - | - | - |
Percentage ever smoked | 89.6% | 82.4% | 0.307 | 96.0% | 71.1% | 0.001 * |
Crude OR | 1 (ref) | 1.84 (0.56–5.97) | 0.312 | 1 (ref) | 9.75 (2.06–46.14) | 0.004 * |
Adjusted OR | 1 (ref) | 1.07 (0.24–4.74) | 0.928 | 1 (ref) | 5.20 (0.82–32.95) | 0.080 |
HOXA9 status | - | - | - | - | - | - |
Percentage HOXA9+ | 68.7% | 11.8% | <0.001 * | 80.0% | 24.4% | <0.001 * |
Crude OR | 1 (ref) | 15.80 (5.30–47.06) | <0.001 * | 1 (ref) | 12.36 (4.68–32.64) | <0.001 * |
Adjusted OR | 1 (ref) | 14.27 (4.62–44.06) | <0.001 * | 1 (ref) | 11.95 (4.11–34.75) | <0.001 * |
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Wen, S.W.C.; Andersen, R.F.; Rasmussen, K.; Thomsen, C.B.; Hansen, T.F.; Nederby, L.; Hager, H.; Jakobsen, A.; Hilberg, O. Validating Methylated HOXA9 in Bronchial Lavage as a Diagnostic Tool in Patients Suspected of Lung Cancer. Cancers 2021, 13, 4223. https://doi.org/10.3390/cancers13164223
Wen SWC, Andersen RF, Rasmussen K, Thomsen CB, Hansen TF, Nederby L, Hager H, Jakobsen A, Hilberg O. Validating Methylated HOXA9 in Bronchial Lavage as a Diagnostic Tool in Patients Suspected of Lung Cancer. Cancers. 2021; 13(16):4223. https://doi.org/10.3390/cancers13164223
Chicago/Turabian StyleWen, Sara W. C., Rikke F. Andersen, Kristian Rasmussen, Caroline Brenner Thomsen, Torben Frøstrup Hansen, Line Nederby, Henrik Hager, Anders Jakobsen, and Ole Hilberg. 2021. "Validating Methylated HOXA9 in Bronchial Lavage as a Diagnostic Tool in Patients Suspected of Lung Cancer" Cancers 13, no. 16: 4223. https://doi.org/10.3390/cancers13164223