Post-operative AICS status in completely resected lung cancer patients with pre-operative AICS abnormalities: predictive significance of disease recurrence

Takashi Anayama,Hiroshi Yamamoto,Ryohei Miyazaki,Toshiteru Tokunaga,Kazumasa Orihashi,Atsuko Ikeda,Jiro Okami,Shinya Kikuchi,Kentaro Hirohashi,Masahiko Higashiyama

doi:10.1038/s41598-018-30685-2

Abstract

The AminoIndexTM Cancer Screening (AICS) system, a plasma-free amino acid (PFAA)-based multivariate discrimination index, is a blood screening test for lung cancer based on the comparison of PFAA concentrations between patients with lung cancer and healthy controls. Pre- and post-operative AICS values were compared among 72 patients who underwent curative resection for lung cancer. Post-operative changes in PFAA concentrations were also evaluated. AICS values were classified as rank A (0.0–4.9), B (5.0–7.9), or C (8.0–10.0). Rank B–C patients were evaluated for outcomes and post-operative changes in their AICS values. Twenty-three of the 44 pre-operative rank B–C patients experienced post-operative reductions in AICS rank. Only one patient experienced cancer recurrence. Post-operative changes in PFAA concentrations were associated with the risk of post-operative cancer recurrence (p = 0.001). Multivariate analysis revealed that the absence of a post-operative reduction in AICS rank independently predicted cancer recurrence (hazard ratio: 14.28; p = 0.012). The majority of patients had high pre-operative AICS values and exhibited a reduction in AICS rank after curative resection. However, the absence of a post-operative reduction in AICS rank was associated with cancer recurrence, suggesting that AICS rank may be a sensitive marker of post-operative recurrence.

Highlights

Lung cancer is a leading cause of global morbidity and mortality, with approximately 14 million new cases in 20121
We developed the AminoIndexTM technology, which scores health conditions and the possibility of disease using multivariate analysis with Plasma-free amino acid (PFAA) concentrations included as a variable[7,8]
By comparing and analysing the ratios of 19 genetically encoded PFAAs in plasma samples derived from approximately 2,500 patients with cancer and approximately 15,000 healthy controls, we found that the PFAA concentration ratio was altered in 7 types of cancer, including lung cancer[9,10,11,12,13,14,15,16]

Summary

Introduction

Lung cancer is a leading cause of global morbidity and mortality, with approximately 14 million new cases in 20121. The present study aimed to evaluate post-operative changes in AICS (lung) values among patients who underwent curative resection for lung cancer, as well as the association of these changes with post-operative cancer recurrence. The absence of a post-operative reduction in AICS (lung) rank was associated with cancer recurrence (Table 3).

Results

Conclusion