Buccal Spectral Markers for Lung Cancer Risk Stratification

• Published in: PloS one Vol. 9; no. 10; p. e110157
• Main Authors: Radosevich, Andrew J., Mutyal, Nikhil N., Rogers, Jeremy D., Gould, Bradley, Hensing, Thomas A., Ray, Daniel, Backman, Vadim, Roy, Hemant K.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 09.10.2014; Public Library of Science (PLoS)
• Subjects: Aged; Aged, 80 and over; Backscattering; Biology and Life Sciences; Biomarkers, Tumor - chemistry; Biomarkers, Tumor - metabolism; Biomedical engineering; Buccal mucosa; Cancer; Cancer screening; Carcinogenesis; Carcinogens; Cellular biology; Cheek; Demographics; Demography; Diagnostic systems; Drug dosages; Early Detection of Cancer; Engineering; Engineering and Technology; Fatalities; Female; Fiber optic equipment; Fiber Optic Technology; Fiber optics; Gene expression; Genomics; Health aspects; Health risk assessment; Health risks; Humans; Invasiveness; Lung cancer; Lung diseases; Lung Neoplasms - diagnosis; Lung Neoplasms - metabolism; Lung Neoplasms - pathology; Male; Markers; Medical diagnosis; Medical prognosis; Medical screening; Medicine and Health Sciences; Middle Aged; Mortality; Mouth Mucosa - metabolism; Mouth Mucosa - ultrastructure; Nanostructures - chemistry; Optical fibers; Oral cavity; Pancreas; Patients; Population; Research and Analysis Methods; Risk Factors; Sensitivity; Smoking; Smoking - adverse effects; Spectroscopy; Spectrum analysis; Training; United States > US; Illinois
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0110157

Lung cancer remains the leading cause of cancer deaths in the US with >150,000 deaths per year. In order to more effectively reduce lung cancer mortality, more sophisticated screening paradigms are needed. Previously, our group demonstrated the use of low-coherence enhanced backscattering (LEBS) spectroscopy to detect and quantify the micro/nano-architectural correlates of colorectal and pancreatic field carcinogenesis. In the lung, the buccal (cheek) mucosa has been suggested as an excellent surrogate site in the "field of injury". We, therefore, wanted to assess whether LEBS could similarly sense the presence of lung. To this end, we applied a fiber-optic LEBS probe to a dataset of 27 smokers without diagnosed lung cancer (controls) and 46 with lung cancer (cases), which was divided into a training and a blinded validation set (32 and 41 subjects, respectively). LEBS readings of the buccal mucosa were taken from the oral cavity applying gentle contact. The diagnostic LEBS marker was notably altered in patients harboring lung cancer compared to smoking controls. The prediction rule developed on training set data provided excellent diagnostics with 94% sensitivity, 80% specificity, and 95% accuracy. Applying the same threshold to the blinded validation set yielded 79% sensitivity and 83% specificity. These results were not confounded by patient demographics or impacted by cancer type or location. Moreover, the prediction rule was robust across all stages of cancer including stage I. We envision the use of LEBS as the first part of a two-step paradigm shift in lung cancer screening in which patients with high LEBS risk markers are funnelled into more invasive screening for confirmation.