Validation of Lung EpiCheck, a novel methylation-based blood assay, for the detection of lung cancer in European and Chinese high-risk individuals.

AIM: Lung cancer screening reduces mortality. We aim to validate the performance of Lung EpiCheck, a six-marker panel methylation-based plasma test, in the detection of lung cancer in European and Chinese samples. METHODS: A case-control European training set (n=102 lung cancer cases, n=265 controls) was used to define the panel and algorithm. Two cut-offs were selected, low cut-off (LCO) for high sensitivity and high cut-off (HCO) for high specificity. The performance was validated in case-control European and Chinese validation sets (cases/controls 179/137 and 30/15, respectively). RESULTS: The European and Chinese validation sets achieved AUCs of 0.882 and 0.899, respectively. The sensitivities/specificities with LCO were 87.2%/64.2% and 76.7%/93.3%, and with HCO they were 74.3%/90.5% and 56.7%/100.0%, respectively. Stage I nonsmall cell lung cancer (NSCLC) sensitivity in European and Chinese samples with LCO was 78.4% and 70.0% and with HCO was 62.2% and 30.0%, respectively. Small cell lung cancer (SCLC) was represented only in the European set and sensitivities with LCO and HCO were 100.0% and 93.3%, respectively. In multivariable analyses of the European validation set, the assay's ability to predict lung cancer was independent of established risk factors (age, smoking, COPD), and overall AUC was 0.942. CONCLUSIONS: Lung EpiCheck demonstrated strong performance in lung cancer prediction in case-control European and Chinese samples, detecting high proportions of early-stage NSCLC and SCLC and significantly improving predictive accuracy when added to established risk factors. Prospective studies are required to confirm these findings. Utilising such a simple and inexpensive blood test has the potential to improve compliance and broaden access to screening for at-risk populations.

Characteristics of Antibiotic Resistance of Helicobacter pylori Among Adult Arab and Jewish Populations in Northern Israel.

AIMS: Following reports from various doctors regarding increased treatment failure in Helicobacter pylori infection among the Arab population, we decided to make a prospective comparison between the resistance rates of H. pylori in the Arab and Jewish populations in northern Israel. RESULTS: Among the Arab population, higher resistance rates were found for clarithromycin and levofloxacin (LEV), as well as a higher rate of multidrug resistance. Rifampin and LEV were found to have higher resistance rates in the village, whereas LEV had a higher resistance rate among women. CONCLUSIONS: Helicobacter pylori in the Arab population compared with the Jewish population in northern Israel is more resistant to treatment. We assume that these results are caused by overexposure combined with unwise use of antibiotics. A correlation was also found between the type of residence and resistance rates to various antibiotics. Further research is needed to determine the resistance mechanism that may explain these results. Due to the high resistance rate and treatment failure, it is appropriate to consider replacing the standard treatment of H. pylori in these populations.