A multianalyte algorithm PCR-based blood test outperforms single analyte ELISA-based blood tests for neuroendocrine tumor detection
Poster Mar 26, 2014
Mark Kidd, Irvin M Modlin, Daniele Alaimo, Stephen Callahan, Nancy Teixiera, Lisa Bodei, Ignat Drozdov
A key issue in management of neuroendocrine tumors (NETs) is specific and sensitive biomarkers. Measurements of single analytes in blood are widely utilized but have significant limitations. We developed a 51 transcript blood NET signature and compared it with standard approaches.
Methods: The multigene signature was evaluated in prospectively collected NETs (n=41, 61% small intestinal, 50% metastatic, 44% under treatment). These were age (NETs: mean 56.9 years, range: 31-76; controls: mean 56.4, range: 33-75) and sex-matched (M:F 10:31) with controls (1:1). Samples were analyzed by 2-step PCR protocol and ELISAs: (DAKO-CgA), pancreastatin (CusaBio-PST) and neurokinin A (RayBiotech-NKA). Sensitivity comparisons included chi-square, non-parametric measurements and ROC analyses.
Results: The NETest identified thirty eight of 41 NETs with equivalent performance metrics: sensitivity/specificity 93% and an AUC of 0.96. For the single analyte ELISA assays, metrics ranged from 31-93% and AUCs from 0.55-0.67. The multigene transcript NETest significantly outperformed single analyte tests (Z-statistic=4.85-6.58, p<0.0001).
Conclusions: A 51 panel multigene blood transcript analysis is significantly more sensitive and efficient (>93%) than any single analyte assay (CgA, PST or NKA) for NET detection. Our data indicate that a blood-based multigene analytic measurement will provide increased sensitivity and specificity in minimally invasive disease detection.
When there is a need to quickly analyze samples using a number of different PCR assays, it is likely that optimal conditions for each assay will not be the same. First, different assays often will require different annealing temperatures for their primers. In addition, amplicons may be designed to be of different lengths and therefore require varying durations of the extension step.READ MORE