الفهرس 
LUNG CANCEROnly 14 pages are availabe for public view
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Abstract
L
ung cancer represents a major health problem world wide as it is the most frequent cause of death from cancer among men and is the third leading cause of cancer mortality among women (Hammerschmidt and Wirtz, 2005). The five-year survival rate is as low as 15%; this is attributed to the fact that only 30% of lung cancer patients present at an early stage of the disease (Simon and Turissi, 2007 and Mark and Leschben, 2009).
Broncoscopy guided-biopsy is considered the most applied diagnostic procedure of lung carcinoma that allows direct assessment of tumor. However, the technique is considered invasive and peripheral lesions are not accessible by it. Many tumor markers have been studied in lung cancer however; their role in the diagnosis and prognosis of lung cancer is still unclear and under research.
In this regards, the aim of our study was to assess the value of serum osteopontin assay as a biomarker in patients with lung carcinoma.
The study was conducted on twenty five (25) newly diagnosed lung carcinoma patients at different stages of the disease attended at the Chest Department of Ain Shams University Hospitals. Patients were classified into subgroup1 which included 9 patients with localized lung cancer; and subgroup2 which included 16 patients with metastasic lung cancer. In addition, 25 apparently healthy subjects served as control group.
All patients in this study were subjected to full history taking, thorough clinical examination, routine laboratory investigations including CBC, ESR and C-reactive protein, Radiological investigations including Chest X-ray, CT-scan and bone scan (if metastasis is suspected) and histopathological examination of broncoscopy or ultrasound guided biopsy (in patients, group only). Furthermore, serum osteopontin (OPN) assay was performed for both patients and control subjects by ELISA technique.
In the present study, serum level of osteopontin was significantly higher in patients’ group as compared to control group (p<0.01). Moreover, serum osteopontin was significantly higher in smoker subjects when compared to non-smoker subjects (p<0.05).
Serum osteopontin was significantly higher in patients with metastases (lymph node or distant metastases) when compared to patients with localized non-metastasizing lung cancer (p<0.01). However no significant difference was found between both sexes and between different histopathological types regarding serum osteopontin (p>0.05 for both parameters).
Correlation study revealed the presence of a highly significant positive correlation between serum osteopontin and ESR (p<0.01). It showed significant positive correlations between serum osteopontin with each of the smoking duration and number of cigarettes smoked per day respectively (p<0.05 for both parameters). Meanwhile, it showed a highly significant negative correlation between serum osteopontin and Hb (p<0.01). However, it showed no correlation between serum osteopontin and age (p>0.05).
Diagnostic performance of osteopontin as a predictor of presence of metastases showed that the best cutoff was 30ng/mL with a diagnostic sensitivity of 87.5%, specificity of 88.9%, PPV of 93.3%, NPV of 80% and diagnostic efficiency of 88%.
In conclusion, osteopontin could be used as a promising non-invasive tumor marker for prognosis of lung cancer and for early detection of metastatic stage hence improving disease prognosis.