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Gregory J. Riely, MD, PhD


Is Mass Spectrometry Useful in Detecting NSCLC Metastasis to Lymph Nodes?

By: Celeste L. Dixon
Posted: Thursday, February 1, 2024

Liquid chromatography–tandem mass spectrometry potentially may offer high diagnostic accuracy and be clinically applied to auxiliary diagnostic procedures for non–small cell lung cancer (NSCLC) that has metastasized to the lymph nodes. Ryuichi Yoshimura, MD, of Iwate Medical University, Japan, and colleagues reported their research results in Thoracic Cancer.

The team used an X500R instrument to analyze 81 lymph nodes from patients with resected NSCLC that had been confirmed by histopathology to have positive expression of cytokeratin (CK) 19, a known useful biomarker in this disease. The investigators considered a positive result for lymph node metastasis to be the detection of at least two product ions (FGPGVAFR and ILGATIENSR) from CK19.

“Our study indicated a high diagnostic efficiency for mass spectrometry, with 87.5% sensitivity and 91.2% specificity,” they wrote. “The mutual concordance of mass spectrometry methods and histopathological diagnosis was 90.1%.” These figures compare favorable with those achieved historically by one-step nucleic acid amplification, according to the study authors.

Dr. Yoshimura and co-investigators noted some specific advantages of the mass spectrometry method, including that measurement is possible even with minute amounts of sample and that multiple patterns can be differentiated in one analysis. In addition, they stated, “the time for analysis can be shortened by narrowing the analysis windows, potentially allowing application to rapid intraoperative diagnosis.”

Disclosure: The study authors reported no conflicts of interest.

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