• Piotr Widlak, Monika Pietrowska, Joanna Polanska, Michal Marczyk, Malgorzata Ros-Mazurczyk, Rafał Dziadziuszko, Jacek Jassem, and Witold Rzyman.
• Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, ul. Wybrzeże Armii Krajowej 15, 44-100 Gliwice, Poland. Electronic address: widlak@io.gliwice.pl.
• Lung Cancer. 2016 Sep 1; 99: 46-52.

ObjectivesCirculating molecular biomarkers of lung cancer may allow the pre-selection of candidates for computed tomography screening or increase its efficacy. We aimed to identify features of serum mass profile distinguishing individuals with early lung cancer from healthy participants of the lung cancer screening program.MethodsBlood samples were collected during a low-dose computed tomography (LD-CT) screening program performed by one institution (Medical University of Gdansk, Poland). MALDI-ToF mass spectrometry was used to characterize the low-molecular-weight (1000-14,000Da) serum fraction. The analysis comprised 95 patients with early stage lung cancer (including 30 screen-detected cases) and a matched group of 285 healthy controls. The cases were split into two independent cohorts (discovery and validation), analyzed separately 6 months apart.ResultsSeveral molecular components of serum (putatively components of endogenous peptidome) discriminating patients with early lung cancer from controls were identified in a discovery cohort. This allowed building an effective cancer classifier as a model tuned to maximize negative predictive value, with an area under the curve (AUC) of 0.88, a negative predictive value of 100%, and a positive predictive value of 48%. However, the classifier performed worse in a validation cohort including independent sample sets (AUC 0.73, NPV 88% and PPV 30%).ConclusionsWe developed a serum mass profile-based signature identifying patients with early lung cancer. Although this marker has insufficient value as a stand-alone preselecting tool for LD-CT screening, its potential clinical usefulness in evaluation of indeterminate pulmonary nodules deserves further investigation.Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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