Preoperative AminoIndex Cancer Screening (AICS) abnormalities predict postoperative recurrence in patients undergoing curative resection for non-small cell lung cancer

Masahiko Higashiyama,Tomohiro Maniwa,Fumio Imamura,Hiroshi Yamamoto,Jiro Okami,Toru Kimura,Ryohei Miyazaki,Shinya Kikuchi,Takashi Anayama,Kentaro Hirohashi,Kazumasa Orihashi

doi:10.1186/s12885-020-07575-w

Masahiko Higashiyama, Tomohiro Maniwa + Show 9 more

Open Access

https://doi.org/10.1186/s12885-020-07575-w

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Abstract

BackgroundAminoIndex™ Cancer Screening (AICS (lung)) was developed as a screening test for lung cancer using a multivariate analysis of plasma-free amino acid (PFAA) profiles. According to the developed index composed of PFAA, the probability of lung cancer was categorized into AICS (lung) ranks A, B, and C in order of increasing risk. The aim of the present study was to investigate the relationship between the preoperative AICS (lung) rank and surgical outcomes in patients who underwent curative resection for non-small cell lung cancer (NSCLC).MethodsPreoperative blood samples were collected from 297 patients who underwent curative resection for NSCLC between 2006 and 2015. PFAA concentrations were measured. The relationship between the preoperative AICS (lung) rank and clinicopathological factors was examined. The effects of the preoperative AICS (lung) rank on postoperative outcomes were also analyzed.ResultsThe AICS (lung) rank was A in 93 patients (31.3%), B in 82 (27.6%), and C in 122 (41.1%). The AICS (lung) rank did not correlate with any clinicopathological factors, except for age. Based on follow-up data (median follow-up period of 6 years), postoperative recurrence was observed in 22 rank A patients (23.7%), 15 rank B (18.3%) and 49 rank C (40.2%). In the univariate analysis, preoperative AICS (lung) rank C was a worse factor of recurrence-free survival (p = 0.0002). The multivariate analysis identified preoperative AICS (lung) rank C (HR: 2.17, p = 0.0005) as a significant predictor of postoperative recurrence, particularly in patients with early-stage disease or adenocarcinoma.ConclusionPreoperative AICS (lung) rank C is a high-risk predictor of postoperative recurrence in patients undergoing curative resection for NSCLC.

Highlights

AminoIndexTM Cancer Screening (AICS) was developed as a screening test for lung cancer using a multivariate analysis of plasma-free amino acid (PFAA) profiles
We reported that the majority of lung cancer patients with high preoperative AICS values exhibited a reduction in AICS rank after curative resection, but that the absence of postoperative reduction in AICS rank was strongly associated with tumor recurrence [10]
Standard surgery for lung cancer was more frequently selected for rank C (p = 0.053)

Summary

Introduction

AminoIndexTM Cancer Screening (AICS (lung)) was developed as a screening test for lung cancer using a multivariate analysis of plasma-free amino acid (PFAA) profiles. Amino acids are one of the most suitable candidates for focused metabolomics because they are ingested or endogenously synthesized and play important physiological roles as essential metabolites and their regulators [1,2,3,4,5,6] Based on these findings, we developed a novel cancer screening test for the early detection of various types of cancers using AminoIndexTM technology, which scores health conditions and the probability of disease by a multivariate analysis with plasma-free amino acid (PFAA) concentrations included as a variable [1, 2]. Since higher AICS (lung) values are associated with an increased risk of lung cancer, when judged as rank C in the screening, medical work-up for lung cancer is recommended as needed [1, 7,8,9]

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