Abstract
Lung cancer remains the leading cause of cancer-related death worldwide. Since prognosis and treatment outcomes rely on fast and accurate diagnosis, there is a need for more cost-effective, sensitive, and specific method for lung cancer detection. Thus, this study aimed to determine the ability of ATR-FTIR in discriminating malignant from benign lung tissues and evaluate its concordance with H&E staining. Three (3) 5μm-thick sections were cut from formalin fixed paraffin embedded (FFPE) cell or tissue blocks from patients with lung lesions. The outer sections were H&E-stained and sent to two (2) pathologists to confirm the histopathologic diagnosis. The inner section was deparaffinized by standard xylene method and then subjected to ATR-FTIR analysis. Distinct spectral profiles that distinguished (p<0.05) one sample from another, called the “fingerprint region”, were observed in five (5) peak patterns representing the amides, lipids, and nucleic acids. Principal component analysis and hierarchical cluster analysis evidently clustered the benign from malignant tissues. ATR-FTIR showed 97.73% sensitivity, 92.45% specificity, 94.85% accuracy, 91.49% positive predictive value and 98.00% negative predictive value in discriminating benign from malignant lung tissue. Further, strong agreement was observed between histopathologic readings and ATR-FTIR analysis. This study shows the potential of ATR-FTIR spectroscopy as a potential adjunct method to the gold standard, the microscopic examination of hematoxylin and eosin (H&E)-stained tissues, in diagnosing lung cancer.
Highlights
Lung cancer remains a global burden being the leading cause of cancer-related death in both men and women, accounting for 18.6% of total cancer-related death worldwide [1,2,3]
Lung cancer is a heterogenous group of tumors which can be divided into two (2) main categories: (1) the non-small cell lung carcinoma (NSCLC) which accounts for 85% of lung cancers and (2) the small cell lung carcinoma (SCLC) [5]
A cell block is prepared by centrifugation of this specimen to recover the lung tissue fragments, formalin fixed, processed, and paraffin-embedded following standard protocols
Summary
Lung cancer remains a global burden being the leading cause of cancer-related death in both men and women, accounting for 18.6% of total cancer-related death worldwide [1,2,3]. Since no effective screening method is available, the disease is usually diagnosed at an advanced stage, resulting to a poor 5-year survival rate estimated at 16% [4]. Lung cancer is a heterogenous group of tumors which can be divided into two (2) main categories: (1) the non-small cell lung carcinoma (NSCLC) which accounts for 85% of lung cancers and (2) the small cell lung carcinoma (SCLC) [5]. NSCLC is further subclassified into adenocarcinoma (40%), squamous cell carcinoma (30%), and large cell carcinoma (10%) based on their histogenetic and immunohistochemical characteristics [5]. Patients suspected of lung cancer usually experience persistent cough, dyspnea, shortness of breath, hemoptysis, chest pain, weight loss, and cachexia [8]
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