A Gene Expression Classifier from Whole Blood Distinguishes Benign from Malignant Lung Nodules Detected by Low-Dose CT.

Low-dose CT (LDCT) is widely accepted as the preferred method for detecting pulmonary nodules. However, the determination of whether a nodule is benign or malignant involves either repeated scans or invasive procedures that sample the lung tissue. Noninvasive methods to assess these nodules are needed to reduce unnecessary invasive tests. In this study, we have developed a pulmonary nodule classifier (PNC) using RNA from whole blood collected in RNA-stabilizing PAXgene tubes that addresses this need. Samples were prospectively collected from high-risk and incidental subjects with a positive lung CT scan. A total of 821 samples from 5 clinical sites were analyzed. Malignant samples were predominantly stage 1 by pathologic diagnosis and 97% of the benign samples were confirmed by 4 years of follow-up. A panel of diagnostic biomarkers was selected from a subset of the samples assayed on Illumina microarrays that achieved a ROC-AUC of 0.847 on independent validation. The microarray data were then used to design a biomarker panel of 559 gene probes to be validated on the clinically tested NanoString nCounter platform. RNA from 583 patients was used to assess and refine the NanoString PNC (nPNC), which was then validated on 158 independent samples (ROC-AUC = 0.825). The nPNC outperformed three clinical algorithms in discriminating malignant from benign pulmonary nodules ranging from 6-20 mm using just 41 diagnostic biomarkers. Overall, this platform provides an accurate, noninvasive method for the diagnosis of pulmonary nodules in patients with non-small cell lung cancer. SIGNIFICANCE: These findings describe a minimally invasive and clinically practical pulmonary nodule classifier that has good diagnostic ability at distinguishing benign from malignant pulmonary nodules.

Genome-wide maps of circulating miRNA biomarkers for ulcerative colitis.

Inflammatory Bowel Disease--comprised of Crohn's Disease and Ulcerative Colitis (UC)--is a complex, multi-factorial inflammatory disorder of the gastrointestinal tract. In this study we have explored the utility of naturally occurring circulating miRNAs as potential blood-based biomarkers for non-invasive prediction of UC incidences. Whole genome maps of circulating miRNAs in micro-vesicles, Peripheral Blood Mononuclear Cells and platelets have been constructed from a cohort of 20 UC patients and 20 normal individuals. Through Significance Analysis of Microarrays, a signature of 31 differentially expressed platelet-derived miRNAs has been identified and biomarker performance estimated through a non-probabilistic binary linear classification using Support Vector Machines. Through this approach, classifier measurements reveal a predictive score of 92.8% accuracy, 96.2% specificity and 89.5% sensitivity in distinguishing UC patients from normal individuals. Additionally, the platelet-derived biomarker signature can be validated at 88% accuracy through qPCR assays, and a majority of the miRNAs in this panel can be demonstrated to sub-stratify into 4 highly correlated intensity based clusters. Analysis of predicted targets of these biomarkers reveal an enrichment of pathways associated with cytoskeleton assembly, transport, membrane permeability and regulation of transcription factors engaged in a variety of regulatory cascades that are consistent with a cell-mediated immune response model of intestinal inflammation. Interestingly, comparison of the miRNA biomarker panel and genetic loci implicated in IBD through genome-wide association studies identifies a physical linkage between hsa-miR-941 and a UC susceptibility loci located on Chr 20. Taken together, analysis of these expression maps outlines a promising catalog of novel platelet-derived miRNA biomarkers of clinical utility and provides insight into the potential biological function of these candidates in disease pathogenesis.

Large-scale integration of microarray data reveals genes and pathways common to multiple cancer types.

The global gene expression analysis of cancer and healthy tissues typically results in large numbers of genes that are significantly altered in cancer. Such data, however, has been difficult to interpret due to the high level of variation of gene lists across laboratories and the small sample sizes used in individual studies. In this investigation, we compiled microarray data obtained from the same platform family from 84 laboratories, resulting in a database containing 1,043 healthy tissue samples and 4,900 cancer samples for 13 different tissue types. The primary cancers considered included adrenal gland, brain, breast, cervix, colon, kidney, liver, lung, ovary, pancreas, prostate and skin tissues. We normalized the data together and analyzed subsets for the discovery of genes involved in normal to cancer transformation. Our integrated significance analysis of microarrays approach produced top 400 gene lists for each of the 13 cancer types. These lists were highly statistically enriched with genes already associated with cancer in research publications excluding microarray studies (p < 1.31 E - 12). The genes MTIM and RRM2 appeared in nine and TOP2A in eight lists of significantly altered genes in cancer. In total, there were 132 genes present in at least four gene lists, 11 of which were not previously associated with cancer. The list contains 17 metal ions and 15 adenyl ribonucleotide binding proteins, six kinases and six transcription factors. Our results point to the value of integrating microarray data in the study of combination drug therapies targeting metastasis.

Asymmetric microarray data produces gene lists highly predictive of research literature on multiple cancer types.

BACKGROUND: Much of the public access cancer microarray data is asymmetric, belonging to datasets containing no samples from normal tissue. Asymmetric data cannot be used in standard meta-analysis approaches (such as the inverse variance method) to obtain large sample sizes for statistical power enrichment. Noting that plenty of normal tissue microarray samples exist in studies not involving cancer, we investigated the viability and accuracy of an integrated microarray analysis approach based on significance analysis of microarrays (merged SAM) using a collection of data from separate diseased and normal samples. RESULTS: We focused on five solid cancer types (colon, kidney, liver, lung, and pancreas), where available microarray data allowed us to compare meta-analysis and integrated approaches. Our results from the merged SAM significantly overlapped gene lists from the validated inverse-variance method. Both meta-analysis and merged SAM approaches successfully captured the aberrances in the cell cycle that commonly occur in the different cancer types. However, the integrated SAM analysis replicated the known cancer literature (excluding microarray studies) with much more accuracy than the meta-analysis. CONCLUSION: The merged SAM test is a powerful, robust approach for combining data from similar platforms and for analyzing asymmetric datasets, including those with only normal or only cancer samples that cannot be utilized by meta-analysis methods. The integrated SAM approach can also be used in comparing global gene expression between various subtypes of cancer arising from the same tissue.