NETest Liquid Biopsy Is Diagnostic of Lung Neuroendocrine Tumors and Identifies Progressive Disease.

BACKGROUND: There are no effective biomarkers for the management of bronchopulmonary carcinoids (BPC). We examined the utility of a neuroendocrine multigene transcript "liquid biopsy" (NETest) in BPC for diagnosis and monitoring of the disease status. AIM: To independently validate the utility of the NETest in diagnosis and management of BPC in a multicenter, multinational, blinded study. MATERIAL AND METHODS: The study cohorts assessed were BPC (n = 99), healthy controls (n = 102), other lung neoplasia (n = 101) including adenocarcinomas (ACC) (n = 41), squamous cell carcinomas (SCC) (n = 37), small-cell lung cancer (SCLC) (n = 16), large-cell neuroendocrine carcinoma (LCNEC) (n = 7), and idiopathic pulmonary fibrosis (IPF) (n = 50). BPC were histologically classified as typical (TC) (n = 62) and atypical carcinoids (AC) (n = 37). BPC disease status determination was based on imaging and RECIST 1.1. NETest diagnostic metrics and disease status accuracy were evaluated. The upper limit of normal (NETest) was 20. Twenty matched tissue-blood pairs were also evaluated. Data are means ± SD. RESULTS: NETest levels were significantly increased in BPC (45 ± 25) versus controls (9 ± 8; p < 0.0001). The area under the ROC curve was 0.96 ± 0.01. Accuracy, sensitivity, and specificity were: 92, 84, and 100%. NETest was also elevated in SCLC (42 ± 32) and LCNEC (28 ± 7). NETest accurately distinguished progressive (61 ± 26) from stable disease (35.5 ± 18; p < 0.0001). In BPC, NETest levels were elevated in metastatic disease irrespective of histology (AC: p < 0.02; TC: p = 0.0006). In nonendocrine lung cancers, ACC (18 ± 21) and SCC (12 ± 11) and benign disease (IPF) (18 ± 25) levels were significantly lower compared to BPC level (p < 0.001). Significant correlations were evident between paired tumor and blood samples for BPC (R: 0.83, p < 0.0001) and SCLC (R: 0.68) but not for SCC and ACC (R: 0.25-0.31). CONCLUSIONS: Elevated -NETest levels are indicative of lung neuroendocrine neoplasia. NETest levels correlate with tumor tissue and imaging and accurately define clinical progression.

[Patient with haemoptysis, dyspnoea, fever and lung infiltration]. / Chory z krwiopluciem, dusznoscia , stanami goraczkowymi i naciekiem w plucach.

In this study we presented the case of 55 years old man who was admitted to the Dept. of Lung Diseases and Tuberculosis in Zabrze with haemoptysis, dyspnoea, fever and lung infiltration. Initially the neoplastic disease was diagnosed. From the information gathered from the patient's family it was stated that the patient has been taking acenocoumarol for a considerably long time without any professional supervision. In this study we emphasize the importance of motivating and informing patients about the purposefulness of control examinations while using this kind of drugs.

[Diagnostic difficulties in diffuse pulmonary infiltrations]. / Trudnosci diagnostyczne zmian rozsianych w plucach.

We described a case of 26-year-old woman, with the history of cough and exercise dyspnoea. Chest X-ray and HRCT examination showed diffuse interstitial infiltration. Histopathological examination of supraclavicular lymph nodes and lung tissue obtained by transbronchial biopsy revealed metastatic adenocarcinoma. Despite several examinations, including gastroscopy- the primary site of cancer was not established. Rapid progression of the disease led to death. Post-mortem examination revealed diffuse gastric carcinoma as the primary neoplasm.

[Invasive pulmonary aspergillosis as a complication of prolonged antibiotic therapy]. / Aspergiloza inwazyjna pluc jako powiklanie dlugotrwalej antybiotykoterapii.

In this study we present the case of 53 year old woman hospitalized in the Department of Lung Diseases and Tuberculosis in Zabrze, Silesian Medical University in Katowice, due to chronic cough and infiltration in the chest radiogram. Prior to the admission, the patient received long-lasting antibiotic ambulatory treatment leveled at laryngobronchitis. After admission the patient underwent bronchofiberoscopy during which a sample for mycological examination of bronchoalveolar lavage was taken. The result of the examination made possible to give the diagnosis--invasive pulmonary aspergillosis. Proper antifungal treatment was used and in consequence considerable improvement in both clinical and radiological state was achieved. Invasive pulmonary aspergillosis is mostly diagnosed in immunocompromised patients. The patient described in this case had none risk factors. Based on that particular case we may state a hypothesis that a prolonged antibiotic therapy is an important risk factor of invasive pulmonary aspergillosis incidence.