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Novel Humoral Prognostic Markers in Small-Cell Lung Carcinoma: A Prospective Study
PURPOSE: Favourable small cell lung carcinoma (SCLC) survival outcomes have been reported in patients with paraneoplastic neurological disorders (PNDs) associated with neuronal antibodies (Neur-Abs), but the presence of a PND might have expedited diagnosis. Our aim was to establish whether neuronal...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4659625/ https://www.ncbi.nlm.nih.gov/pubmed/26606748 http://dx.doi.org/10.1371/journal.pone.0143558 |
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author | Gozzard, Paul Chapman, Caroline Vincent, Angela Lang, Bethan Maddison, Paul |
author_facet | Gozzard, Paul Chapman, Caroline Vincent, Angela Lang, Bethan Maddison, Paul |
author_sort | Gozzard, Paul |
collection | PubMed |
description | PURPOSE: Favourable small cell lung carcinoma (SCLC) survival outcomes have been reported in patients with paraneoplastic neurological disorders (PNDs) associated with neuronal antibodies (Neur-Abs), but the presence of a PND might have expedited diagnosis. Our aim was to establish whether neuronal antibodies, independent of clinical neurological features, correlate with SCLC survival. EXPERIMENTAL DESIGN: 262 consecutive SCLC patients were examined: of these, 24 with neurological disease were excluded from this study. The remaining 238 were tested for a broad array of Neur-Abs at the time of cancer diagnosis; survival time was established from follow-up clinical data. RESULTS: Median survival of the non-PND cohort (n = 238) was 9.5 months. 103 patients (43%) had one or more antigen-defined Neur-Abs. We found significantly longer median survival in 23 patients (10%) with HuD/anti-neuronal nuclear antibody type 1 (ANNA-1, 13.0 months P = 0.037), but not with any of the other antigen-defined antibodies, including the PND-related SOX2 (n = 56, 24%). An additional 28 patients (12%) had uncharacterised anti-neuronal nuclear antibodies (ANNA-U); their median survival time was longer still (15.0 months, P = 0.0048), contrasting with the survival time in patients with non-neuronal anti-nuclear antibodies (detected using HEp-2 cells, n = 23 (10%), 9.25 months). In multivariate analyses, both ANNA-1 and ANNA-U independently reduced the mortality hazard by a ratio of 0.532 (P = 0.01) and 0.430 (P<0.001) respectively. CONCLUSIONS: ANNAs, including the newly described ANNA-U, may be key components of the SCLC immunome and have a potential role in predicting SCLC survival; screening for them could add prognostic value that is similar in magnitude to that of limited staging at diagnosis. |
format | Online Article Text |
id | pubmed-4659625 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-46596252015-12-02 Novel Humoral Prognostic Markers in Small-Cell Lung Carcinoma: A Prospective Study Gozzard, Paul Chapman, Caroline Vincent, Angela Lang, Bethan Maddison, Paul PLoS One Research Article PURPOSE: Favourable small cell lung carcinoma (SCLC) survival outcomes have been reported in patients with paraneoplastic neurological disorders (PNDs) associated with neuronal antibodies (Neur-Abs), but the presence of a PND might have expedited diagnosis. Our aim was to establish whether neuronal antibodies, independent of clinical neurological features, correlate with SCLC survival. EXPERIMENTAL DESIGN: 262 consecutive SCLC patients were examined: of these, 24 with neurological disease were excluded from this study. The remaining 238 were tested for a broad array of Neur-Abs at the time of cancer diagnosis; survival time was established from follow-up clinical data. RESULTS: Median survival of the non-PND cohort (n = 238) was 9.5 months. 103 patients (43%) had one or more antigen-defined Neur-Abs. We found significantly longer median survival in 23 patients (10%) with HuD/anti-neuronal nuclear antibody type 1 (ANNA-1, 13.0 months P = 0.037), but not with any of the other antigen-defined antibodies, including the PND-related SOX2 (n = 56, 24%). An additional 28 patients (12%) had uncharacterised anti-neuronal nuclear antibodies (ANNA-U); their median survival time was longer still (15.0 months, P = 0.0048), contrasting with the survival time in patients with non-neuronal anti-nuclear antibodies (detected using HEp-2 cells, n = 23 (10%), 9.25 months). In multivariate analyses, both ANNA-1 and ANNA-U independently reduced the mortality hazard by a ratio of 0.532 (P = 0.01) and 0.430 (P<0.001) respectively. CONCLUSIONS: ANNAs, including the newly described ANNA-U, may be key components of the SCLC immunome and have a potential role in predicting SCLC survival; screening for them could add prognostic value that is similar in magnitude to that of limited staging at diagnosis. Public Library of Science 2015-11-25 /pmc/articles/PMC4659625/ /pubmed/26606748 http://dx.doi.org/10.1371/journal.pone.0143558 Text en © 2015 Gozzard et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Gozzard, Paul Chapman, Caroline Vincent, Angela Lang, Bethan Maddison, Paul Novel Humoral Prognostic Markers in Small-Cell Lung Carcinoma: A Prospective Study |
title | Novel Humoral Prognostic Markers in Small-Cell Lung Carcinoma: A Prospective Study |
title_full | Novel Humoral Prognostic Markers in Small-Cell Lung Carcinoma: A Prospective Study |
title_fullStr | Novel Humoral Prognostic Markers in Small-Cell Lung Carcinoma: A Prospective Study |
title_full_unstemmed | Novel Humoral Prognostic Markers in Small-Cell Lung Carcinoma: A Prospective Study |
title_short | Novel Humoral Prognostic Markers in Small-Cell Lung Carcinoma: A Prospective Study |
title_sort | novel humoral prognostic markers in small-cell lung carcinoma: a prospective study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4659625/ https://www.ncbi.nlm.nih.gov/pubmed/26606748 http://dx.doi.org/10.1371/journal.pone.0143558 |
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