preprints.org > medicine and pharmacology > oncology and oncogenics > doi: 10.20944/preprints202408.1275.v1

Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 16 August 2024 / Approved: 16 August 2024 / Online: 19 August 2024 (12:18:11 CEST)

Lung cancer remains the most common cancer worldwide with a limited prognosis despite personalized treatment regimens. Low-dose computed tomography (CT) scanning as a means to early diagnosis has been disappointing due to the high false positive rate. Other non-invasive means of testing need to be developed that offer both timely diagnosis and predict prognosis. Methods: In the course of stool testing in a large-scale testing of 2,922 patients at increased risk of CRC we were able to ascertain 112 patients documented to have prospectively been diagnosed with lung cancer. Stool and colonic effluents were tested for p87 with anti-adenoma antibody (Adnab-9) reactivity by ELISA and western blot. Survival data were obtained where available. Results: Of 112 cancers, approximately 27.6% were squamous (SSC), 17.9% were adenocarcinoma, 8% small, 6.25% large cell and 3.57% were designated non-small cell cancer (NSCLC), 0.89% indeterminate, 0.89% lepidic spread (1), 3.57% had metastasis and in 31.25% data was unavailable. 49.1% of the lung cancer patients had fecal Adnab-9 testing. Overall, 60% had positive testing compared to 38%, which was significant (OR2.19[1/06-4.53];p=0.045). Cancers with higher lethality were less likely to test positive (approximately, 8.5% each for both small and large cell lung cancers), and higher, 56% with SCC and 25% for adenocarcinoma. 0% NSCLC). In the larger groups overall survival was worse in those testing positive: 474 testing positive versus 844 days in SCC and 54 testing positive versus 749 days in adenocarcinoma patients. Most importantly, the time from a positive test to the clinical diagnosis ranged from 2.72 years for small cell, 3.13 for adenocarcinoma, 5.07 for NSCLC, 6.07 for SSC, and 6.24 for large cell cancer. In excluded cases where cancer in the lung was believed to be metastatic,83.3% of cancers were positive. Conclusions: At a projected real-world sensitivity of 0.60 and specificity of 0.60 and the ability to predate diagnosis by up to 4.7 years overall, this test could help direct lung cancer screening. In addition, the Adnab-9 testing selectively detects worse tumor types (87.5%) and those with worse prognosis amongst the more common, favorable phenotypes thus making early diagnosis possible in those patients who stand to benefit most from this strategy. Metastatic lung cancer also detected by the test should be identified by the follow-up imaging studies and therefore would not be considered to be a major pitfall.

lung cancer; Adnab-9; colorectal cancer; NSCLC; SCC; ADENOCARCINOMA

Medicine and Pharmacology, Oncology and Oncogenics

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