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Shanqing Li
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P1.04 - Immuno-oncology (ID 164)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Immuno-oncology
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 09:45 - 18:00, Exhibit Hall
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P1.04-74 - Characteristics of T Cell Receptor Repertoire of Lung Cancer Patients (Now Available) (ID 1554)
09:45 - 18:00 | Author(s): Shanqing Li
- Abstract
Background
As the importance of T cell receptor (TCR) repertoire gains appreciation, particularly given their potential utility for cancer immunotherapeutic prognostication, the characteristics of TCR repertoire are needed. We detected the complementarity determining region 3 (CDR3) by TCR sequence to describe diversity and changes in human’s immune system with age and difference clinical stage .
Method
The TCRβ repertoire of 19 stage IV lung cancer patients and 77 stage I/II/III lung cancers patients was analyzed. Genomic DNA was extracted from peripheral blood and used to amplified and sequenced the CDR3 region of rearranged TCRβ genes. Finally, we got the relative frequencies of patients T cell clones. Shannon index was calculated on the clonal abundance of all productive TCR sequences. The normalized Shannon index was determined by dividing Shannon index by the natural logarithm of the number of unique productive TCR sequences.
Result
Diversity of the TCR repertoire can be measured using the Shannon index. Analysis had been made to test the diversity relationship among a cluster of clinical features, such as stages, age and gender. Diversity were significantli decreasing with clinical stages(p=0.0482). Comparison of the diversity between stage IV and stage I/II/III patients, we found stage IV lung cancer has more lower diversity(p=0.0048). In these patients, diversity had showed a significantli correlation with age(r=-0.3036, p=0.0026). Diversity was significantly lower in patients 55 years of age or older compared to younger patients (p=0.0083).
Conclusion
These results suggest that patients with advanced cancer exhibit limited TCR repertoire diversity and that this diversity is further limited in patients with advanced clinical stage and older age. Interestingly, these factors are often associated with a poor immune status.
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P2.11 - Screening and Early Detection (ID 178)
- Event: WCLC 2019
- Type: Poster Viewing in the Exhibit Hall
- Track: Screening and Early Detection
- Presentations: 1
- Now Available
- Moderators:
- Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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P2.11-42 - A Prospective Multicenter Study to Assess Combined 6 Tumor Markers for Early Stage Lung Cancer in Patients with Lung Nodule (Now Available) (ID 1583)
10:15 - 18:15 | Author(s): Shanqing Li
- Abstract
Background
Lung cancer (LC) is one of the most prevalent and fatal cancer worldwide. The prognosis of LC is closely related to the stage. Low-dose computed tomography (LDCT) is recommended for LC screening in high risk population. More and more lung nodules were detected, but only less than 4% patients were LC. Also, the access to LDCT scan for the high risk population was very low. We conducted a prospective, multicenter study to assess the diagnostic accuracy of combined 6 tumor markers (TMs, CEA, CYFRA21-1, CA15-3, SCC, NSE and ProGRP) for aid in diagnosis in lung nodule patients.
Method
Patients, ≥18years old, who were newly diagnosed with lung nodules, 8‑30 mm, by CT scan were prospectively recruited. Blood samples were obtained by peripheral venipuncture in all patients before the final diagnosis had been established. The patients were divided into two groups according to the pathology result or clinical diagnosis: LC group and benign lung nodule group. The 6 serum TMs were tested for all patients. When these six TMs were assessed in combination, the presence of ≥1 abnormal TM values were considered as abnormal. Sensitivity (SN), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV) were calculated and the area under the receiver operating characteristic curve (AUC) was analyzed.
Result
A total 492 predominant lung nodules patients were included in the study analysis, with median age of 59 (IQR: 53-66) years old. 59.6% of the patients were female and 67.5% were non-smokers. Median lung nodule size was 15.75 mm (IQR: 11.75-21.00). 374 (76.02%) patients were diagnosed with LC, of which 94% patients were at I-II stage. SN, SP, PPV, and NPV of the combined 6 markers for LC diagnosis were 39.57% (95%CI, 34.62%, 44.53%), 75.42% (95%CI, 67.66%, 83.19%), 83.62% (95%CI: 78.16%, 89.07%) and 28.25% (95%CI, 23.28%, 33.23%), respectively. AUC showed the combined 6 markers had better diagnostic performance than each individual marker.
Conclusion
Combined 6 TMs increased the diagnostic performance for LC, comparing to the use of individual marker. Given its higher specificity, the presence of ≥1 abnormal TM values could support LC diagnosis in patients with predominant lung nodule detected by CT scan.
