Plasma cell-free DNA levels and integrity in patients with chest radiological findings: NSCLC versus benign lung nodules

Cancer Lett. 2016 May 1;374(2):202-7. doi: 10.1016/j.canlet.2016.02.002. Epub 2016 Feb 5.


Effective discrimination between lung cancer and benign tumours is a common clinical problem in the differential diagnosis of solitary pulmonary nodules. The analysis of cell-free DNA (cfDNA) in blood may greatly aid the early detection of lung cancer by evaluating cancer-related alterations. The plasma cfDNA levels and integrity were analysed in 65 non-small cell lung cancer (NSCLC) patients, 28 subjects with benign lung tumours, and 16 healthy controls using real-time PCR. The NSCLC patients demonstrated significantly higher mean plasma cfDNA levels compared with those with benign tumours (P = 0.0009) and healthy controls (P < 0.0001). The plasma cfDNA integrity in healthy individuals was significantly different than that found in patients with NSCLC or benign lung tumours (P < 0.0003). In ROC curve analysis, plasma cfDNA levels >2.8 ng/ml provided 86.4% sensitivity and 61.4% specificity in discriminating NSCLC from benign lung pathologies and healthy controls. cfDNA integrity showed better discriminatory power (91% sensitivity, 68.2% specificity). These data demonstrate that plasma cfDNA concentration and integrity analyses can significantly differentiate between NSCLC and benign lung tumours. The diagnostic capacity of the quantitative cfDNA assay is comparable to the values presented by conventional imaging modalities used in clinical practice.

Keywords: Benign lung nodules; Cell-free DNA; Concentration; Integrity; Non-small cell lung cancer; Plasma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / blood
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Case-Control Studies
  • DNA, Neoplasm / blood*
  • DNA, Neoplasm / genetics
  • Diagnosis, Differential
  • Female
  • Humans
  • Lung Diseases / blood
  • Lung Diseases / diagnosis*
  • Lung Diseases / diagnostic imaging
  • Lung Diseases / genetics
  • Lung Neoplasms / blood
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / genetics
  • Male
  • Middle Aged
  • Multiple Pulmonary Nodules / blood
  • Multiple Pulmonary Nodules / diagnosis*
  • Multiple Pulmonary Nodules / diagnostic imaging
  • Multiple Pulmonary Nodules / genetics
  • Radiography
  • Young Adult


  • DNA, Neoplasm