Abstract

Recent advances in the treatment of non-small cell lung cancer (NSCLC) with new agents require accurate histological subtyping at diagnosis to avoid the higher risk of an adverse response and to obtain the maximum therapeutic response. However, interobserver variability, tumor heterogeneity and the degree of differentiation may affect the decision concerning a pathological diagnosis of NSCLC. Therefore, the aim of this study was to identify specific microRNAs (miRNAs) as standardized biomarkers with high sensitivity and specificity in order to distinguish between squamous cell carcinoma (SCC) and adenocarcinoma (AC). Quantitative polymerase chain reaction (qPCR)‑based miRNA array analysis was performed to identify microRNAs differentially expressed between SCC and AC using 86 resected NSCLC samples in addition to adjacent normal tissues. The results were confirmed by independent qRT-PCR assays with the same test samples and 88 additional validation samples, and from this we evaluated the usefulness of the identified miRNAs as biomarkers to distinguish between SCC and AC. Three miRNAs (hsa-miR-196b, hsa-miR-205 and hsa-miR-375) were identified. Discriminant analysis combining the three miRNAs appeared to distinguish SCC from AC accurately in the test and validation samples, demonstrating a sensitivity and specificity of 76 and 80%, and 85 and 83%, respectively. hsa-miR-196b, hsa-miR-205 and hsa-miR-375 were identified as biomarkers capable of distinguishing between lung SCC and lung AC. These newly identified miRNAs may prove to be highly valuable molecular markers for the classification of NSCLC histological subtypes and may contribute to the pathogenesis of each subtype of NSCLC.

Highlights

  • IntroductionThe main type of lung cancer is non-small cell lung cancer (NSCLC), which may be divided into three histologic subtypes: squamous-cell carcinoma (SCC), adenocarcinoma (AC), and large-cell lung carcinoma (LCC) [1]

  • Lung cancer is the leading cause of cancer mortalities worldwide

  • The main type of lung cancer is non-small cell lung cancer (NSCLC), which may be divided into three histologic subtypes: squamous-cell carcinoma (SCC), adenocarcinoma (AC), and large-cell lung carcinoma (LCC) [1]

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Summary

Introduction

The main type of lung cancer is non-small cell lung cancer (NSCLC), which may be divided into three histologic subtypes: squamous-cell carcinoma (SCC), adenocarcinoma (AC), and large-cell lung carcinoma (LCC) [1]. Analysis of a phase III study with pemetrexed demonstrated that survival was superior in non-squamous NSCLCs compared to SCC [2,3]. This finding may be explained by the fact that thymidylate synthase, one of the main targets of pemetrexed, was found to be differentially expressed among the histotypes of lung cancer, with a lower expression in AC and a higher expression in SCC and small-cell lung cancer [4,5]. Histological characterization is the milestone for tailored therapy, which is important in order to maximize the benefits of novel drugs and to avoid hazardous side effects

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