ABSTRACT
A stage I non-small cell lung cancer (NSCLC) serum profiling platform is presented which is highly efficient and accurate. Test sensitivity (0.95) for stage I NSCLC is the highest reported so far. Test metrics are reported for discriminating stage I adenocarcinoma vs squamous cell carcinoma subtypes. Blinded analysis identified 23 out of 24 stage I NSCLC and control serum samples. Group-discriminating mass peaks were targeted for tandem mass spectrometry peptide/protein identification, and yielded a lung cancer phenotype. Bioinformatic analysis revealed a novel lymphocyte adhesion pathway involved with early-stage lung cancer.
Subject(s)
Adenocarcinoma/blood , Biomarkers, Tumor/blood , Carcinoma, Non-Small-Cell Lung/blood , Carcinoma, Squamous Cell/blood , Lung Neoplasms/blood , Proteomics/methods , Tandem Mass Spectrometry , Adenocarcinoma/immunology , Adenocarcinoma/pathology , Adenocarcinoma of Lung , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/immunology , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Squamous Cell/immunology , Carcinoma, Squamous Cell/pathology , Case-Control Studies , Cell Adhesion , Computational Biology , Databases, Protein , Diagnosis, Differential , Female , Humans , Lung Neoplasms/immunology , Lung Neoplasms/pathology , Lymphocytes/immunology , Lymphocytes/metabolism , Male , Middle Aged , Neoplasm Staging , Phenotype , Predictive Value of TestsABSTRACT
BACKGROUND: Home anticoagulation testing (HAT) may be useful for rural patients who cannot attend an anticoagulation service clinic (ASC). Interest in HAT is unknown and was the focus of this study. MATERIALS AND METHODS: Anticoagulated patients from two clinics, the ASC and vascular surgery clinic (VSC) were surveyed and compared for demographics, anticoagulation knowledge and opinions, and HAT interest. Logistic regression was performed, using the entire patient cohort, to identify factors associated with HAT interest. RESULTS: There were 211 (141 ASC, 70 VSC) patients surveyed. Differences between the ASC and VSC patients included education level (13.2 versus 12.1 years; P = 0.02), time spent testing (60.5 +/- 33.5 versus 46.4 +/- 20.7 min; P = 0.001), use of fingerstick testing (90% versus 2.9%; P < 0.001), and knowledge of the potential interaction of warfarin with medications or diet (79% versus 59% P = 0.003). HAT interest was similar (62.1% ASC versus 50% VSC; P = 0.14). Factors associated with HAT interest included employment [odds ratio (OR) 2.9, 95% confidence interval (CI) 1.2-6.7], knowledge of potential interactions between medications and warfarin (OR 3.9, 95% CI 1.9-8.1), and a willingness to check international normalized ratio values more frequently if recommended (OR 2.4, 95% CI 1.2-4.6). Patients who received family help with medications appeared less interested in HAT (OR 0.29, 95% CI 0.12-0.68). CONCLUSIONS: A slight majority of surveyed rural patients conveyed interest in HAT. Working patients and those assuming more responsibility for international normalized ratio control may be more interested in HAT. A possible association between anticoagulation knowledge and increased HAT interest was seen and should be further studied.
