In fact, in many cases, autophagy process is induced by Beclin-1 independent manner

erall survival. Moreover, high serum and pleural effusion concentrations of HE4 were previously observed in NSCLC and Three studies suggested that HE4 could be a potential diagnostic and prognostic marker in NSCLC. The aim of our study was thus to determine the diagnostic and prognostic value of HE4 serum level using 346 samples from a serum biobank dedicated to the validation of biomarkers in lung cancer and following the REMARK guidelines. Materials and Methods Patients Serum samples from 346 MedChemExpress 1022150-57-7 consecutive patients with NSCLC referred to the Montpellier– Nmes University Hospital, France, between January 1995 and December 1997 were used for 2 / 13 HE4 in Lung Cancer this study. These samples are part of a large biobank that was started in 1990 to collect serum samples from patients with NSCLC with the goal of determining prospectively the prognostic impact of new serum tumor markers. Specifically, the biobank protocol defined the clinical variables to be recorded, the eligibility criteria and the statistical methods to be used. PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19709857 The methodology did not change over time. All biobank samples are associated with comprehensive clinical data that were prospectively recorded and samples are stored at–180C. However, this study was retrospective because the decision to test HE4 has been taken only recently. This study was reviewed and approved by the ICM Institutional Review Board called “Comit d’Organisation de la Recherche Translationnelle”. According to the French regulation, the consent for secondary use of human biological material is under a legal regime of “non-opposition”: After information for new use from researchers, human biological samples can be used except in case of opposition from the donor. Then, inform consent was not obtained from the patients but patient records/information was anonymized and de-identified prior to analysis. Only serum samples from patients with NSCLC histologically proven and previously untreated NSCLC were used for this study. NSCLC cancers were classified according to the WHO histological classification; however, the last revision concerning the new taxonomy of adenocarcinomas was not taken into account and adenocarcinoma was considered as a generic sub-histologic type. Performance status was estimated using the Eastern Cooperative Oncology Group score and the percentage of weight loss during the previous four months was recorded. Staging was carried out according to the Union for International Cancer Control tumor node metastasis classification in use at the time of diagnosis and the American Thoracic Society map of regional pulmonary nodes. The following investigations were carried out: clinical examination, standard chest roentgenography, computed tomography scan of chest, upper abdomen and brain, fiberoptic bronchoscopy, liver sonography and bone scintigraphy. Mediastinoscopy was performed to establish the node status in patients with non-metastatic NSCLC, but evidence of mediastinal lymph node enlargement on the chest CT images. Controls Serum samples were collected from 41 consecutive patients with non-malignant pulmonary diseases. Patients in the control group have similar median age and sex ration than patients in the lung cancer group. Treatment A medical panel composed of thoracic surgeons, chest physicians, radiologists, radiotherapists PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19710274 and medical oncologists discussed each patient’s medical record. Patients with stage I-II NSCLC or resectable IIIa disease underwent surgery with the aim of ac