Breackthrough in lung cancer diagnosis

© Shutterstock
© Shutterstock
Early diagnosis of lung cancer is a critical public health problem. Smoking is the main risk factor for this cancer and is responsible for 81% of cases. Worldwide number of smokers is estimated to reach the billion in 2014, which means that in the world, one in seven people has or may develop such a cancer while survival prognosis about 5 years is only 1% in the majority of cases.
Therefore, it is of considerable importance to find new methods for early detection of lung cancer, especially among the so-called « high-risk » populations, and thus try to contain or even reduce the number of death.


New tracks of research

A 2008 study shows that the migration of circulating tumor cells (CTC) into the blood may be an early event in human carcinogenesis. Indeed, experimental data stemmed from animal models showed that the early stage of tumor development can be associated with the presence of CTCs in the blood. However, this study has been so far conducted on patients with an established diagnosis of cancer.

In 2010, another researchers’ team concluded their study by stating that detection of low-dose CTC can be associated with a decrease of 20% in mortality from lung cancer.

The study

It is according to these new findings that the team of Dr. Hofman, Chief of Pulmonary Medicine Department at the University Hospital of Nice (Pastor Hospital), decided to conduct a pilot study over 4 years to investigate more deeply the CTC on a new population of patients. The main objective of this study was to find an early method of detection through a new cancer marker, the CTCs, thanks to an easy blood test (in addition to a CT scan).

245 subjects were followed from June 2008 to April 2012. Among these subjects, 168 were suffering from chronic obstructive pulmonary disease (COPD), a predisposing disease to lung cancer, the 77 others being in good health, and smokers for a half.

CTCs were detected for 5 among 168 patients with COPD (between 19 and 67 CTC detected on average), which increased their radiological monitoring by CT-scan.

After 3.2 years on average, a nodule appeared and these patients underwent a cancer surgery the month after.

16 months after the operation, tests showed no cancer recurrence, and no CTC was detected.


This study, which still need to be validated in other hospitals and on other patient cohorts in France, shows for the first time that CTC can be detected in population with COPD but without clinically detectable lung cancer, and turns out to be a « world first » in the history of the fight against cancer.