Clinical Significance Of Measuring CEA, ET-1, VEGF And Let-7 In Exhaled Breath Condensate Of Patients With Non-small Cell Lung Cancer

Part Ⅰ Detection of cancer embryo antigen and endothelin-1 in exhaledbreath condensate of Patients with non small cell lung cancerObjective: This study aimed to investigate the clinical significance of cancer embryo antigen(CEA) and endothelin-1(ET-1) in the exhaled breath condensate(EBC) of patients with non-small cell lung cancer(NSCLC).Methods: We collected EBC samples from 143 patients with NSCLC and 119 healthy individuals by using an EBC collector. The CEA and ET-1 levels in the EBC and serum were detected.Results: The CEA and ET-1 levels in the serum and EBC of the NSCLC group were higher than those of the healthy group. The CEA level in the EBC of the adenocarcinoma group was higher than that in the squamous cell carcinoma group. The CEA and ET-1 levels in the serum and EBC in stages III and IV were higher than those in stages I and II. The CEA and ET-1 levels in the EBC were positively correlated with those in the serum. The CEA and ET-1 levels in the EBC exhibited high specificity and sensitivity; thus, these parameters can be used to diagnose lung cancer.Conclusion: The detection of CEA and ET-1 in EBC can help diagnose and monitor the progression of NSCLC.Part Ⅱ The detection of VEGF in exhaled breath condensate of ofPatients with non small cell lung cancerObjective: To study the clinical significance of vascular endothelial growth factor(VEGF) in exhaled breath condensate(EBC) of non small cell lung cancer(NSCLC) patients.Methods: We collected EBC samples by the EBC collector from 132 cases of NSCLC patients, 62 cases of pulmonary benign lesions, 97 cases of healthy check-up. Enzyme-linked immunosorbent assay( ELISA)was used for detection of VEGF in EBC and serum.Results: The VEGF levels of serum and EBC in NSCLC group higher than benign lesions group and healthy group. The EBC VEGF level in phase III and IV stage of NSCLC group was obviously higher than that of phase I and II stage.The VEGF levels in serum and EBC of the death group were higher than that in the survival group. VEGF level in EBC was positively correlated with VEGF level in serum, the correlation coefficient was 0.613(P<0.01). Using ROC curve analysis showed that the area under the EBC curve(0.922) was larger than the area under the serum curve(0.802). The diagnostic sensitivity of EBC VEGF level in lung cancer(87.9%) was higher than that of serum way(65.9%).Conclusions: VGEF detection in EBC had important value in the diagnosis, monitoring disease progression and prognosis of NSCLC. The detection of VEGF in EBC could be more helpful for NSCLC than serum. Part Ⅲ The clinical significance of let-7 of exhaled breath condensate ofnon-small cell lung cancerObjective: To investigate the clinical significance of let-7 in exhaled breath condensate(EBC) that was collected in non-small cell lung cancer patients.Methods: we analyzed the expression levels of let-7 from 180 specimens by real-time fluorescent quantitative polymerase chain reaction(RT-qPCR), which consisted of 30 NSCLC patients(lung cancer tissues, paracarcinoma tissues, serum, and EBC), and 30 healthy volunteers(serum and EBC).Results: The levels of let-7 from three samples(tumor tissues, serum, EBC) in NSCLC was significantly lower than that in the control group(all, P<0.001). The expression of let-7 of above mentioned three specimens in NSCLC decreased with the progress of disease(TNM stage, lymph node metastasis)(all, P<0.05). On the contrary, there was no correlation among let-7 and other clinicopathological characteristics(age, sex, smoking, histopathological classification). The area under the EBC curve(AUC) of let-7 of lung cancer tissue was 0.894, and the specificity and sensitivity respectively was 90%, 93.3%. The AUC of serum let-7 in NSCLC diagnosis was 0.771, and its specificity and sensitivity respectively was 86.7%, 60%. The AUC of let-7 in EBC was 0.750, and the specificity and sensitivity respectively was 76.7%, 66.7%. So the detection of let-7 in EBC was feasibility.Conclusions: The examination method of let-7 from EBC provided a satisfactory diagnostic efficiency for NSCLC patients. And it could be a significant biomarker for the diagnosis and severity evaluation about NSCLC patients.