Abstract 4176: The biology of circulating nucleic acid in non-small cell lung cancer and prognostic implication

Abstract

Abstract Background: Increased amount of circulating nucleic acid in plasma or serum (CNAPS) of cancer patient had been confirmed in many studies. The source of CNAPS was still enigmatic however the correlation with prognostic outcome was confirmed in various types of cancer. These might be the effect of tumor-derived CNAPS, correlated with tumor burden; however the interaction of cancer and immune cell was not negligent. Material and Method: Fifty-eight plasma of advanced non-small cell lung cancer (NSCLC) and 52 sex/age match healthy volunteer were studied. Total amount of CNAPS was measured. We further explored substantial biology proportion of CNAPS according to cell source by using epithelial-specific marker, methylated SHP-1 promoter 2 (mSHP1P2), and hematopoietic-specific marker, unmethylated SHP-1 promoter 2 (uSHP1P2). Clinicopathological parameters were included with these markers evaluation. Result: Significantly increased amount of CNAPS in plasma of NSCLC compared with healthy volunteer. Median levels were 7.6 ngml-1 (range 1.3-49.8) and 4.6 ngml-1 (range 0.03-26.9) respectively (p = 0.002). The mSHP1P2 represented the increasing amount of tumor-derived CNAPS in NSCLC (p < 0.001). Contrast to uSHP1P2 which was the predominant portion of CNAPS in healthy volunteer. The mSHP1P2 level was correlated with prognostic strategy in NSCLC. Moreover proportion of uSHP1P2 level was also increased among NSCLC and it was related with survival outcome. Comparison CNAPS, mSHP1P2 and uSHP1P2 with baseline demographic parameters by multivariate analysis, total amount of CNAPS was the only independent parameter for prognostic assessment. The level of > 4.5 ngml-1 indicated shorter median PFS (2.6 months) and OS (4.7 months) while the level of < 4.5 ngml-1 indicated longer median PFS (5.6 months) and OS (>15 months) (p < 0.001). Conclusion: Total amount of CNAPS in NSCLC was the valuable prognostic implication confirmed by our study, the impact of both tumor and immune cell-derived portion. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4176. doi:10.1158/1538-7445.AM2011-4176