Abstract
BackgroundTorque teno virus (TTV) is a ubiquitous non-pathogenic virus, which is suppressed in immunological healthy individuals but replicates in immune compromised patients. Thus, TTV load is a suitable biomarker for monitoring the immunosuppression also in lung transplant recipients. Since little is known about the changes of TTV load in lung cancer patients, we analyzed TTV plasma DNA levels in lung cancer patients and its perioperative changes after lung cancer surgery.Material and methodsPatients with lung cancer and non-malignant nodules as control group were included prospectively. TTV DNA levels were measured by quantiative PCR using DNA isolated from patients plasma and correlated with routine circulating biomarkers and clinicopathological variables.Results47 patients (early stage lung cancer n = 30, stage IV lung cancer n = 10, non-malignant nodules n = 7) were included. TTV DNA levels were not detected in seven patients (15%). There was no significant difference between the stage IV cases and the preoperative TTV plasma DNA levels in patients with early stage lung cancer or non-malignant nodules (p = 0.627). While gender, tumor stage and tumor histology showed no correlation with TTV load patients below 65 years of age had a significantly lower TTV load then older patients (p = 0.022). Regarding routine blood based biomarkers, LDH activity was significantly higher in patients with stage IV lung cancer (p = 0.043), however, TTV load showed no correlation with LDH activity, albumin, hemoglobin, CRP or WBC. Comparing the preoperative, postoperative and discharge day TTV load, no unequivocal pattern in the kinetics were.ConclusionOur study suggest that lung cancer has no stage dependent impact on TTV plasma DNA levels and confirms that elderly patients have a significantly higher TTV load. Furthermore, we found no uniform perioperative changes during early stage lung cancer resection on plasma TTV DNA levels.
Highlights
The ubiquitous Torque teno virus (TTV) has a high prevalence of about 90% in the population worldwide [1,2,3]
TTV DNA levels were not detected in seven patients (15%)
There was no significant difference between the stage IV cases and the preoperative TTV plasma DNA levels in patients with early stage lung cancer or non-malignant nodules (p = 0.627)
Summary
The ubiquitous Torque teno virus (TTV) has a high prevalence of about 90% in the population worldwide [1,2,3] It was initially detected in 1997 in a patient with post transfusion hepatitis in Japan [4]. TTV is a single stranded circular Anellovirus from the Circoviridae family of about 3.8 kilobases [5] It leads to a low viremia in immune competent hosts [6]. TTV DNA plasma loads were found to be elevated in patients under immunosuppression after lung transplantation and other solid organ transplantations [16, 18]. TTV plasma DNA levels can be used as a marker for monitoring the extent of immunosuppression in lung [20], kidney [21] and liver transplant recipients [22]. Since little is known about the changes of TTV load in lung cancer patients, we analyzed TTV plasma DNA levels in lung cancer patients and its perioperative changes after lung cancer surgery
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