基于前列腺、肺、结直肠和卵巢队列的肺癌血液生物标志物组的死亡率优势

SCI

18 July 2023

Mortality Benefit of a Blood-Based Biomarker Panel for Lung Cancer on the Basis of the Prostate, Lung, Colorectal, and Ovarian Cohort

(Journal of clinical oncology, IF: 45.3)

Irajizad E, Fahrmann JF, Marsh T, Vykoukal J, Dennison JB, Long JP, Do KA, Feng Z, Hanash S, Ostrin EJ. Mortality Benefit of a Blood-Based Biomarker Panel for Lung Cancer on the Basis of the Prostate, Lung, Colorectal, and Ovarian Cohort. J Clin Oncol. 2023 Jun 28:JCO2202424. doi: 10.1200/JCO.22.02424. Epub ahead of print. PMID: 37379494.

CORRESPONDING AUTHOR：Edwin Ostrin, MD, PhD, MD Anderson Cancer Center, 6767 Bertner Ave, Houston, TX 77030; e-mail: EJOstrin@mdanderson.org.

Purpose 目的

To investigate the utility of integrating a panel of circulating protein biomarkers in combination with a risk model on the basis of subject characteristics to identify individuals at high risk of harboring a lethal lung cancer.

研究将一组循环蛋白生物标志物与基于受试者特征的风险模型相结合的效用，以识别患致命性肺癌高风险的个体。

Methods 方法

Data from an established logistic regression model that combines four-marker protein panel (4MP) together with the Prostate, Lung, Colorectal, and Ovarian (PLCO) risk model (PLCOm2012) assayed in prediagnostic sera from 552 lung cancer cases and 2,193 noncases from the PLCO cohort were used in this study. Of the 552 lung cancer cases, 387 (70%) died of lung cancer. Cumulative incidence of lung cancer death and subdistributional and cause-specific hazard ratios (HRs) were calculated on the basis of 4MP + PLCOm2012 risk scores at a predefined 1.0% and 1.7% 6-year risk thresholds, which correspond to the current and former US Preventive Services Task Force screening criteria, respectively.

本研究采用的数据来自已建立的逻辑回归模型，该模型将四标记蛋白组 (4MP) 与前列腺、肺、结直肠和卵巢 (PLCO) 风险模型 (PLCOm2012) 结合起来，在来自PLCO队列中的 552 例肺癌病例和 2,193 例非病例的诊断前血清中进行检测。本研究使用了 PLCO 队列。在552例肺癌病例中，387例（70%）死于肺癌。肺癌死亡的累积发生率以及亚分布和特定原因风险比 (HR) 是根据 4MP+PLCOm2012 风险评分在预定义的 1.0% 和 1.7% 6 年风险阈值计算得出的，分别对应于当前和以前的美国预防服务工作组筛选标准。

Results 结果

When considering cases diagnosed within 1 year of blood draw and all noncases, the area under receiver operation characteristics curve estimate of the 4MP + PLCOm2012model for risk prediction of lung cancer death was 0.88 (95% CI, 0.86 to 0.90). The cumulative incidence of lung cancer death was statistically significantly higher in individuals with 4MP + PLCOm2012scores above the 1.0% 6-year risk threshold (modified χ2, 166.27; P < .0001). Corresponding subdistributional and lung cancer death-specific HRs for test-positive cases were 9.88 (95% CI, 6.44 to 15.18) and 10.65 (95% CI, 6.93 to 16.37), respectively.

当考虑抽血一年内诊断的病例和所有非病例时，用于肺癌死亡风险预测的 4MP+PLCOm2012 模型的受试者操作特征曲线下面积估计值为 0.88（95% CI，0.86 至 0.90）。4MP 1 PLCOm2012 评分高于 1.0% 6年风险阈值的个体中，肺癌死亡的累积发生率在统计学上显著较高（修正 χ2 , 166.27；P < .0001）。测试阳性病例相应的亚分布和肺癌死亡特异性 HR 分别为 9.88（95% CI，6.44 至 15.18）和 10.65（95% CI，6.93 至 16.37）。

Conclusions 结论

The blood-based biomarker panel in combination with PLCOm2012identifies individuals at high risk of a lethal lung cancer.

基于血液的生物标志物组与 PLCOm2012 相结合，可以识别出罹患致命肺癌的高风险个体。