Validation of a risk model for stage I lung adenocarcinoma

I 期肺腺癌风险模型的验证

• 批准号: 8386244
• 负责人: Prasad S. Adusumilli
• 金额: $ 24.19万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-10 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8386244
• 关键词: Adjuvant Therapy; Aftercare; Cessation of life; Characteristics; Chest; Clinical; Complex; Data; Databases; Development; Diagnosis; Disclosure; Early Diagnosis; Excision; Formalin; Foundations; Goals; Hematoxylin and Eosin Staining Method; Hospitals; Individual; Intervention; Lung Adenocarcinoma; Malignant neoplasm of lung; Methods; MicroRNAs; Modeling; Nomograms; Non-Small-Cell Lung Carcinoma; Oncologist; Operative Surgical Procedures; Outcome; Paraffin Embedding; Pathologic; Patients; Performance; Prognostic Factor; Prognostic Marker; Protocols documentation; Publications; Publishing; Recurrence; Research Personnel; Research Proposals; Risk; Screening procedure; Slide; Specimen; Staging; Surgeon; Testing; Thoracic Surgeon; Tissue Sample; Tissues; Validation; Variant; X-Ray Computed Tomography; cohort; cost effective; experience; high risk; improved; instrument; lung cancer screening; prognostic; tissue processing; tool; tumor

DESCRIPTION (provided by applicant): Development and validation of a prognostic model for predicting recurrence in stage I lung adenocarcinoma. With the recent disclosure of results from the National Lung Cancer Screening Trial, suggesting that annual chest CT scans can reduce 20% of lung cancer deaths in high-risk individuals, the number of early stage LACs detected by screening CT scans and their resection is expected to increase. While the 5-year recurrence rate following curative-intent surgical resection in stage I LAC is 18% - 29%, there is substantial individual variation in post-resection recurrence free survival. Currently, the only accepted prognostic factor guiding treatment decisions for both surgeons and oncologists is tumor size, and its prognostic performance remains unclear. Better prognostic tools are needed to provide good quality individual risk prediction, identify patients at high risk of recurrence and help to guide treatment decisions by both oncologists and thoracic surgeons. In an attempt to identify prognostic markers that accurately predict the risk of unfavorable outcome; our group has performed extensive clinical and pathological examination of the largest cohort of stage I LAC to date. We have developed a prediction score that uses combined clinical, histological and cytological criteria that can be assessed routinely on an H&E slide in any hospital, and predicts the risk of recurrence or death with high accuracy. In this proposal, we aim to further improve the predictive ability of our score by microRNA analysis (miRNA). The potential of using microRNAs for prognostication of early lung cancer has been established by several investigators independently including our group. We have developed a microRNA signature capable of prognostication of early lung cancer. A distinct advantage of our methods is the use of formalin-fixed paraffin-embedded (FFPE) tissue, similar to our clinico-pathologic criteria, thus avoiding the requirement of complex tissue processing protocols. We hypothesize that the comprehensive clinico-pathological score, enriched with miRNA expression data, can be combined into a simple, cost-effective predictive instrument that will accurately determine the risk of recurrence or death following curative-intent surgical resection for stage I LAC, and will identify those patients who are primary candidates for aggressive surveillance and adjuvant therapy. In this proposal, we seek to validate and refine our existing miRNA signature for LAC and examine its ability to enrich the predictive quality of our clinico-pathological score. As the model is built upon simple clinical, pathological characteristics (assessed on H&E slide) and miRNA analysis from FFPE, the results of our proposal are immediately implementable, timely and are of high translational significance. PUBLIC HEALTH RELEVANCE: Detection of early stage lung cancer is anticipated to increase necessitating more accurate predictive instruments to identify patients at higher risk for recurrence. In this proposal, we combine our expertise of pathological, cytological and microRNA analyses to develop and validate a comprehensive risk model to identify patients at a higher risk for recurrence for aggressive surveillance or intervention.

描述（由申请人提供）：开发和验证预测I期肺腺癌复发的预后模型。最近公布的国家肺癌筛查试验结果表明，每年胸部CT扫描可使高危人群肺癌死亡率降低20%，因此通过筛查CT扫描发现的早期lac及其切除的数量有望增加。虽然I期LAC术后5年复发率为18% - 29%，但仍有相当大的