Complement factor H autoantibodies are associated with early stage NSCLC

Abstract

Purpose: To discover diagnostic biomarkers associated with early-stage non-small cell lung cancer (NSCLC), we searched for autoantibodies preferentially present in stage I patients compared with patients with advanced-stage disease. Here we describe an autoantibody against complement factor H (CFH) and this autoantibody's association with early-stage NSCLC.

Experimental design: Immunoblots were used to detect autoantibodies in the sera of stage I NSCLC patients. An autoantibody recognizing a 150 kDa protein was discovered, and the protein was identified by mass spectrometry. The association of the autoantibody with early-stage disease was suggested by the results of immunoblot analysis with sera from 28 stage I patients and 28 stage III/IV patients. This association was confirmed by protein microarray of sera from 125 NSCLC patients of all stages as well as 125 controls matched by age, gender, and smoking history.

Results: The immunoreactive protein was identified as CFH. By immunoblot analysis, anti-CFH autoantibody was found in 50% of stage I NSCLC patients and 11% of late-stage NSCLC patients (P = 0.003). By protein microarray analysis, patients with stage I NSCLC had a significantly higher incidence of anti-CFH antibody than those with late-stage NSCLC (P = 0.0051). The percentage of sera with a positive level of CFH autoantibody was 30.4% in stage I, 21.1% in stage II, 12.5% in stage III, 7.4% in stage IV, and 8.0% in the control group.

Conclusions: These findings suggest that in patients with NSCLC, CFH autoantibody is a molecular marker associated with early-stage disease.

Fig. 1

Immunoblots probed with NSCLC patient sera. A, Pooled serum blot: Ten individual serum samples from patients with stage I NSCLC were used to probe a blot containing the pooled sera from 5 late stage NSCLC patients. B, CFH blot: Individual stage I, stage III/IV and normal serum samples were used to probe a blot containing purified CFH.

Fig. 2

Distribution of microarray spot intensity for CFH autoantibody shown by stage (stage I [n=46], stage II [n=19], stage III [n=32], stage IV [n=27]). The horizontal line represents the median spot intensity for each stage.

Fig. 3

Fraction of sera in all stages of cancer (cancer) vs. control and by stage with a positive level of CFH autoantibody in the microarray. For definition of positivity, the cutoff point is defined as 2SD greater than the mean spot intensity for CFH autoantibody of the control group (0.705), or as the optimal cutoff value determined from ROC analysis (0.600).

Fig. 4

Fraction of sera in early (I/II) and late (III/IV) stage NSCLC with a positive level of CFH autoantibody in the microarray. The cutoff points for positivity are as described in the legend to Fig. 3. For comparison, the proportion of sera in each group defined as positive from a visual assessment of immunoblots is shown.