Differentiation of Malignant Pleural Effusions from Lung Squamous Cell Carcinoma and Adenocarcinoma through FTIR Spectroscopy: A Prognostic Approach
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Introduction: Malignant pleural effusion (MPE) is common in cancer patients and is often caused by neoplastic involvement of the pleural surface. This study aimed to determine the utility of Fourier transform infrared spectroscopy (FTIR) spectral analysis and anatomical pathological differentiation in MPE, squamous cell carcinoma (SCC), and lung adenocarcinoma as prognostic predictors.
Methods: This study used a cross-sectional design at Ulin General Hospital, Banjarmasin, involving advanced lung cancer patients with MPE. A non-probability sampling technique was used to recruit 30 patients. Fourier transform infrared spectroscopy was analyzed to evaluate anatomical pathology differentiation.
Results: Differences were observed in the FTIR spectral ratios A1080/A1243 and A1080/A1170 between SCC and adenocarcinoma, with p-values of 0.026 and 0.022, respectively. Significant differences were also found in the A2959/A1545 ratio between well-differentiated and poorly differentiated adenocarcinomas, with a p-value of 0.023. The receiver-operating characteristic curve (ROC) indicated good predictive value for poorly differentiated adenocarcinoma at a cut-off value of 0.944, with a sensitivity of 50% and specificity of 100%. However, no significant correlation was found between FTIR absorbance and anatomical pathology differentiation in MPE due to SCC and lung adenocarcinoma.
Conclusion: The FTIR spectral ratios A1080/A1243 and A1080/A1170 differentiate SCC from adenocarcinoma. Fourier transform infrared spectroscopy may be an adjunct to cytology, offering a more rapid and cost-effective method for differentiating MPE.
Hastuti T, Kartikasari Y, Abimanyu B, et al. Analisis Informasi Citra Anatomi MSCT Thorax dengan Kasus Efusi Pleura Kanker Paru pada Window Mediastinum Post Kontras Menggunakan Variasi Nilai Window Width. J Imejing Diagnostik 2020; 6: 28–35. [Journal]
Jany B, Welte T. Pleural Effusion in Adults-Etiology, Diagnosis, and Treatment. Dtsch Arztebl Int 2019; 116: 377–386. [PubMed]
Napitupulu E, Soeroso NN, Tarigan SP, et al. Respiratory Emergency in Hospitalized Patient with Intrathoracic Malignancy at H. Adam Malik General Hospital. J Respirologi Indones 2022; 42: 1–8. [Journal]
Zhang Y, Li X, Liu J, et al. Diagnostic Accuracy of the Cancer Ratio for the Prediction of Malignant Pleural Effusion: Evidence from a Validation Study and Meta-Analysis. Ann Med 2021; 53: 558–566. [PubMed]
Tembhare P, Tonge P, Verulkar B, et al. Chest X-Ray Analysis Using Deep Learning Algorithm. Int J Res Appl Sci Eng Technol 2023; 11: 1843–1847. [Journal]
Haryati H, Arganita FR, Oktaviyanti IK. Survival of Lung Adenocarcinoma Patients with Tyrosine Kinase Inhibitor Therapy Based on EGFR Mutation Status in Tumor and Plasma Samples. Indones J Cancer 2023; 17: 280–286. [Proceeding]
Ismida F, Yanti B, Husna C, et al. Profil Sitologi Efusi Pleura di RSUD Zainoel Abidin Banda Aceh. J Kedokt Syiah Kuala 2021; 21: 121–124. [Journal]
Robot RY, Durry MF, Kairupan CF. Morfologi, Patogenesis, dan Imunoterapi Kanker Paru Tipe Adenokarsinoma. Med Scope J 2021; 3: 74–82. [Journal]
Saller JJ, Boyle TA. Molecular Pathology of Lung Cancer. Cold Spring Harb Perspect Med; 12. Epub ahead of print March 2022. [PubMed]
Yuan M, Huang LL, Chen JH, et al. The Emerging Treatment Landscape of Targeted Therapy in Non-Small-Cell Lung Cancer. Signal Transduct Target Ther 2019; 4: 61. [Journal]
Wang BY, Huang JY, Chen HC, et al. The Comparison between Adenocarcinoma and Squamous Cell Carcinoma in Lung Cancer Patients. J Cancer Res Clin Oncol 2020; 146: 43–52. [PubMed]
Asmara OD, Tenda ED, Singh G, et al. Lung Cancer in Indonesia. Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer 2023; 18: 1134–1145. [PubMed]
Bibby AC, Dorn P, Psallidas I, et al. ERS/EACTS Statement on the Management of Malignant Pleural Effusions. Eur J Cardiothorac Surg 2019; 55: 116–132. [PubMed]
Su KY, Lee WL. Fourier Transform Infrared Spectroscopy as a Cancer Screening and Diagnostic Tool: A Review and Prospects. Cancers (Basel); 12. Epub ahead of print January 2020. [PubMed]
Pinto D, Chandra A, Crothers BA, et al. The International System for Reporting Serous Fluid Cytopathology-Diagnostic Categories and Clinical Management. J Am Soc Cytopathol 2020; 9: 469–477. [PubMed]
Gayen S. Malignant Pleural Effusion: Presentation, Diagnosis, and Management. Am J Med 2022; 135: 1188–1192. [PubMed]
Caliri AW, Tommasi S, Besaratinia A. Relationships among Smoking, Oxidative Stress, Inflammation, Macromolecular Damage, and Cancer. Mutat Res Rev Mutat Res 2021; 787: 108365. [PubMed]
Alfarisa S, Mitra E, Wahyuni S. Karakteristik Pasien Kanker Paru di RSUP Dr. M. Djamil Padang Tahun 2021. Sci J 2023; 2: 247–255. [Journal]
Rejeki M, Pratiwi EN. Diagnosis dan Prognosis Kanker Paru, Probabilitas Metastasis dan Upaya Prevensinya. Pros Univ Res Colloq 2020; 0: 73–78. [Proceeding]
Yao S, Campbell PT, Ugai T, et al. Proceedings of the Fifth International Molecular Pathological Epidemiology (MPE) Meeting. Cancer Causes Control 2022; 33: 1107–1120. [PubMed]
Khokhar A, Sharma P. Role of Environmental Factors in Increased Cancer Incidences and Health Impacts BT - Biotechnological Innovations for Environmental Bioremediation. In: Arora S, Kumar A, Ogita S, et al. (eds). Singapore: Springer Nature Singapore, pp. 671–723. [Springer]
Du Y, Cui X, Sidorenkov G, et al. Lung Cancer Occurrence Attributable to Passive Smoking among Never Smokers in China: A Systematic Review and Meta-Analysis. Transl Lung Cancer Res 2020; 9: 204–217. [PubMed]
Liang H, Zhou X, Zhu Y, et al. Association of Outdoor Air Pollution, Lifestyle, Genetic Factors with the Risk of Lung Cancer: A Prospective Cohort Study. Environ Res 2023; 218: 114996. [PubMed]
Wang W, Liu H, Li G. What’s the Difference between Lung Adenocarcinoma and Lung Squamous Cell Carcinoma? Evidence from a Retrospective Analysis in a Cohort of Chinese Patients. Front Endocrinol (Lausanne) 2022; 13: 947443. [PubMed]
Li WJ, Lin ZD, Wang JL. A Narrative Review of Malignant Eosinophilic Pleural Effusion: Incidence, Etiology and Prognostic Significance. Ann Palliat Med 2021; 10: 2314–2322. [PubMed]
Evcil FY, Önal Ö, Özkan EE. The Effect of Body Mass Index on Survival in Lung Cancer. Nutr Cancer 2023; 75: 857–866. [PubMed]
Nigro E, Perrotta F, Scialò F, et al. Food, Nutrition, Physical Activity and Microbiota: Which Impact on Lung Cancer? Int J Environ Res Public Health; 18. Epub ahead of print March 2021. [PubMed]
Yang X, Ou Q, Qian K, et al. Diagnosis of Lung Cancer by ATR-FTIR Spectroscopy and Chemometrics. Front Oncol 2021; 11: 753791. [PubMed]
Sauter JL, Dacic S, Galateau-Salle F, et al. The 2021 WHO Classification of Tumors of the Pleura: Advances Since the 2015 Classification. J Thorac Oncol 2022; 17: 608–622. [Journal]
Qiu L, Yang S, Yang X, et al. Analyses of the Fourier Transform Infrared Spectra of Pleural Mesothelioma Tissues. Opt Spectrosc 2020; 128:1328–1337. [Springer]
Xiu Y, Field MS. The Roles of Mitochondrial Folate Metabolism in Supporting Mitochondrial DNA Synthesis, Oxidative Phosphorylation, and Cellular Function. Curr Dev Nutr 2020; 4: nzaa153. [PubMed]
Wińska P, Sobiepanek A, Pawlak K, et al. Phosphorylation of Thymidylate Synthase and Dihydrofolate Reductase in Cancer Cells and the Effect of CK2α Silencing. International Journal of Molecular Sciences; 24. Epub ahead of print 2023. [Journal]
Kaznowska E, Łach K, Depciuch J, et al. Application of Infrared Spectroscopy for the Identification of Squamous Cell Carcinoma (Lung Cancer). Preliminary Study. Infrared Phys Technol 2018; 89: 282–290. [ScienceDirect]
Bangaoil R, Santillan A, Angeles LM, et al. ATR-FTIR Spectroscopy as Adjunct Method to the Microscopic Examination of Hematoxylin and Eosin-Stained Tissues in Diagnosing Lung Cancer. PLoS One 2020; 15: e0233626. [PubMed]
Liu J, Bian T, She B, et al. Evaluating the Comprehensive Diagnosis Efficiency of Lung Cancer, including Measurement of SHOX2 and RASSF1A Gene Methylation. BMC Cancer 2024; 24: 282. [Journal]
Fernández LP, de Cedrón MG, de Molina AR. Alterations of Lipid Metabolism in Cancer: Implications in Prognosis and Treatment. Front Oncol 2020; 10: 577420. [PubMed]
Che L, Paliogiannis P, Cigliano A, et al. Pathogenetic, Prognostic, and Therapeutic Role of Fatty Acid Synthase in Human Hepatocellular Carcinoma. Front Oncol 2019; 9: 1412. [PubMed]
Guo S, Xiu J, Chen W, et al. Precise Diagnosis of Lung Cancer Enabled by Improved FTIR-Based Machine Learning. Infrared Phys Technol 2023; 132: 104732. [ScienceDirect]
Lasch P, Boese M, Pacifico A, et al. FT-IR Spectroscopic Investigations of Single Cells on the Subcellular Level. Vib Spectrosc 2002; 28: 147–157. [ScienceDirect]
Schlarbaum KE. PET/CT Imaging in Lung Cancer. J Nucl Med Technol 2024; 52: 91–101. [PubMed]
Karpathiou G, Péoc’h M, Sundaralingam A, et al. Inflammation of the Pleural Cavity: A Review on Pathogenesis, Diagnosis and Implications in Tumor Pathophysiology. Cancers (Basel); 14. Epub ahead of print March 2022. [PubMed]
Colthup NB, Daly LH, Wiberley SE. Introduction to Infrared and Raman Spectroscopy. 3rd ed. Elsevier Science, https://books.google.co.id/books?id=SDNRAAAAMAAJ (1990).
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