الفهرس 
ACKNOWLEDGEMENT
PrognosisOnly 14 pages are availabe for public view
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Abstract
This study involved fifty seven patientswith lung cancer aged from (23- 87) years: eleven in stage I, nineteen in stage II, fourteen in stage III and thirteen in stage IV. They were recruited from broncology unit of chest disease department, Assiut University Hospital.
In addition, twenty apparently healthy individuals were selected as a control group for comparison. They aged from (18 - 80) years.
All patients and controls were subjected to the following:
- History of smoking, loss of weight, cough and expectoration, dysnea, drug intake, family history of lung cancer and past history of tuberculosis.
- Clinical examination including: chest, abdominal and lymph node examination.
For patients only
- Chest X ray
- Computed Tomography (CT) chest
- Bronchoscopy
- Pathological examination of lung mass specimen
Laboratory investigations:
I) Routine investigations:
- Complete blood picture.
- Chemical investigations:
1- Random serum glucose
2- Kidney function test.
3- Liver function test.
4- Lactate dehydrogenase.
II) Special investigations:
1- Serum Carcinoembryonic Antigen (CEA).
2- Quantitation of plasma miRNA 155 and miRNA 197 by Real-time polymerase chain reaction (RT-PCR)
In this study there were a significant elevation of serum carcinoembryonic antigen (CEA) levels in both group I and II lung cancer patients compared to control group, in group II compared to group I lung cancer patients and in patients with malignant pleural effusion compared to those without effusion.
There were significant elevations of both micRNA155 and micRNA 197 in both patients groups of lung cancer compared to control group, in group II compared to group I lung cancer patients and in patients with metastasis (pleural effusion) than in those without metastasis.
In present study there was no significant difference between miRNA 155, miRNA 197 and CEA levels in different histopathological types of lung cancer.
There wassignificant elevation of plasma micRNA155, micRNA197 and CEA levels in smokers compared to non smokers among lung cancer patients.
There was a significant elevation of serum CEA level in females compared to males.
No significant difference between males and females regarding both plasma micRNA 155 &micRNA197 levels was observed.
There was no significant difference of serum CEA in lung cancer patients with age <60 years compared to patients with age ≥60 years.
There was a significant elevation of plasma micRNA155 and micRNA197 levels in age group < 60 yrs compared to age group ≥ 60 yrs.
There was significant elevation of serum CEA level in lung cancer patients with tumor size >3 cm compared to patients with tumor size <3 cm and plasma micRNA155 level in lung cancer patients with tumor size <3 cm compared to patients with tumor size ≥3 cm,but, there was no significant difference between plasma micRNA197 in lung cancer patients with tumor size <3 cm compared to patients with tumor size ≥3 cm.
There were significant elevations of serum ALP and LDH in lung cancer patients compared to control group with positive correlation with serum CEA, plasma miRNA 155 and miRNA 197.
To evaluate the role of circulating plasma micRNA155, micRNA197 and serum CEA in lung cancer diagnosis, ROC analysis was performed.The AUC for plasma miRNA 155 and micRNA197 in the whole group of lung cancer patients was 0.722 and 0.699, respectively which mean that both miRNAs can fairly discriminate lung cancer patients from control. But, AUC of CEA was 0.408 that has poor discriminating power.
The study revealed that, CEA at cutoff=28 ng/ml the sensitivity was 74% and the specificity was 100% in lung cancer patients.
In the present study, from ROC curve of patients group the sensitivity was 93% and the specificity was 100% at cutoff=152 fold changes for miRNA155. At cutoff 159.18 fold changes, micRNA197 showed a diagnostic sensitivity of 90% and specificity 100%.
Our study confirms the diagnostic value of plasma miRNA155 and miRNA197 in lung cancer. The use of these markers in combination gave a sensitivity of 94%. However, the combination between serum CEA, plasma miR-155 and miR-197 in lung cancer patients gave the same result.