DNA hypermethylation analysis in sputum of asymptomatic subjects at risk for lung cancer participating in the NELSON trial: Argument for maximum screening interval of 2years

Hubers, A. J., Heideman, D. A. M., Duin, S., Witte, B. I., de Koning, H. J., Groen, H., Prinsen, C. F. M., Bolijn, A. S., Wouters, M., van der Meer, S. E., Steenbergen, R. D. M., Snijders, P. J. F., Uyterlinde, A., Berkhof, H., Smit, E. F. & Thunnissen, E., Mar-2017, In : Journal of Clinical Pathology. 70, 3, p. 250-254 5 p.

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  • DNA hypermethylation analysis in sputum of asymptomatic subjects at risk for lung cancer participating in the NELSON trial: argument for maximum screening interval of 2 years

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  • A. Jasmijn Hubers
  • Danielle A. M. Heideman
  • Sylvia Duin
  • Birgit I. Witte
  • Harry J. de Koning
  • Hendricus Groen
  • Clemens F. M. Prinsen
  • Anne S. Bolijn
  • Mandy Wouters
  • Susanne E. van der Meer
  • Renske D. M. Steenbergen
  • Peter J. F. Snijders
  • Anne Uyterlinde
  • Hans Berkhof
  • Egbert F. Smit
  • Erik Thunnissen

Aims Lung cancer is the major contributor to cancer mortality due to metastasised disease at time of presentation. The current study investigated DNA hypermethylation of biomarkers RASSF1A, APC, cytoglobin, 3OST2, FAM19A4, PHACTR3 and PRDM14 in sputum of asymptomatic high-risk individuals from the NELSON lung cancer low-dose spiral CT screening trial to detect lung cancer at preclinical stage.

Methods Subjects were selected with (i) lung cancer in follow-up (cases; n=65), (ii) minor cytological aberrations (controls; n=120) and (iii) a random selection of subjects without cytological aberrations (controls; n=99). Median follow-up time for controls was 80months. Cut-off values were based on high specificity to assess diagnostic value of the biomarkers.

ResultsRASSF1A may denote presence of invasive cancer because of its high specificity (93% (95% CI 89% to 96%); sensitivity 17% (95% CI 4% to 31%), with best performance in a screening interval of 2 years. The panel of RASSF1A, 3OST2 and PRDM14 detected 28% (95% CI 11% to 44%) of lung cancer cases within 2years, with specificity of 90% (95% CI 86% to 94%). Sputum cytology did not detect any lung cancers.

Conclusions In a lung cancer screening setting with maximum screening interval of 2years, DNA hypermethylation analysis in sputum may play a role in the detection of preclinical disease, but complementary diagnostic markers are needed to improve sensitivity.

Original languageEnglish
Pages (from-to)250-254
Number of pages5
JournalJournal of Clinical Pathology
Issue number3
Publication statusPublished - Mar-2017


Related Datasets
  1. Nederlands-Leuvens Longkanker Screenings Onderzoek (NELSON)

    Oudkerk, M. (Creator), Groen, H. (Creator), Van Klaveren, R. J. (Creator), de Koning, H. J. (Creator), Mali, W. P. T. M. (Creator), Lammers, J. J. (Creator), University of Groningen, 2018


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