Molecular Profiling of Computed Tomography Screen-Detected Lung Nodules Shows Multiple Malignant Features
- María J. Pajares1,6,
- Isabel Zudaire1,7,
- María D. Lozano2,
- Jackeline Agorreta1,6,
- Gorka Bastarrika3,
- Wenceslao Torre4,
- Ana Remírez1,
- Ruben Pio1,8,
- Javier J. Zulueta5 and
- Luis M. Montuenga1,6
- 1Oncology Division, Center for Applied Medical Research; Departments of 2Pathology, 3Radiology, 4Thoracic Surgery, and 5Pulmonary Medicine, Clínica Universitaria de Navarra; and Departments of 6Histology and Pathology, 7Genetics and 8Biochemistry, Schools of Medicine and Sciences, University of Navarra, Pamplona, Spain
- Requests for reprints:
Luis M. Montuenga, Área de Oncología. Centro para la Investigación Médica Aplicada, University of Navarra, Avenida Pío XII, 55, 31008 Pamplona, Spain. Phone: 34-948194700; Fax: 34-948194714. E-mail: lmontuenga{at}unav.es
Abstract
Rationale and Purpose: Low-dose spiral computerized axial tomography (spiral CT) is effective for the detection of small early lung cancers. Although published data seem promising, there has been a significant degree of discussion concerning the potential of overdiagnosis in the context of spiral CT–based screening. The objective of the current study was to analyze the phenotypic and genetic alterations in the small pulmonary malignancies resected after detection in the University of Navarra/International Early Lung Cancer Action Project spiral CT screening trial and to determine whether their malignant molecular features are similar to those of resected lung tumors diagnosed conventionally.
Experimental Design: We analyzed 17 biomarkers of lung epithelial malignancy in a series of 11 tumors resected at our institution during the last 4 years (1,004 high-risk individuals screened), using immunohistochemistry and fluorescence in situ hybridization (FISH). A parallel series of 11 gender-, stage-, and histology-matched lung cancers diagnosed by other means except screening was used as control.
Results: The molecular alterations and the frequency of phenotypic or genetic aberrations were very similar when screen-detected and nonscreen-detected lung cancers were compared. Furthermore, most of the alterations found in the screen-detected cancers from this study were concordant with what has been described previously for stage I-II lung cancer.
Conclusions: Small early-stage lung cancers resected after detection in a spiral CT-based screening trial reveal malignant molecular features similar to those found in conventionally diagnosed lung cancers, suggesting that the screen-detected cancers are not overdiagnosed. (Cancer Epidemiol Biomarkers Prev 2006;15(2):373–80)
Footnotes
-
Grant support: Fundación para la Investigación Médica Aplicada (UTE-CIMA agreement), Fondo de Investigaciones Sanitarias (RITCCC 03/10, PI 04/2128, and PI 02/1116), Departamento de Salud del Gobierno de Navarra (61/2002, 38/2003, and 35/2004), European Union Vth Framework Project (QLRT-2001-01735), and a Prevention Fellowship from the International Association for the Study of Lung Cancer (M.J. Pajares).
-
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
-
- Accepted December 9, 2005.
- Received May 3, 2005.
- Revision received September 9, 2005.
