Glycometabolic, inflammatory and exocrine plasma proteins predict cancer in individuals with cardiovascular disease

Cancer development is associated with systemic immune, metabolic, and tissue disturbances. Researchers investigated if a small set of circulating proteins could predict the onset of cancer in patients with atheromatous cardiovascular disease (ACVD) who smoke. The study utilized a nested case-control approach within the FLEMENGHO cohort, comprising 156 participants, 38 of whom developed lung cancer.

Multi-omic analysis yielded a two-part classifier incorporating four proteins and smoking status, with constant preprocessing for the transfer to PREVALUNG cohort (397 participants, 58 incident cancers, including 26 lung cancers). Low levels of O-GlcNAcase (OGA) and interleukin-6 (IL-6) identified a low-risk group that included one of the 58 cancers (sensitivity 98.3%, negative predictive value 98.8%).

Conversely, low levels of chymotrypsin C (CTRC) and high levels of beta microseminoprotein (MSMB) identified a high-risk group, where 15 of the 28 participants developed cancer. No other omic features improved the classifier under the study's selection criteria. The classifier's accuracy was higher for cancers diagnosed more than 12 months after sampling (AUC 0.766, 95% CI 0.671-0.857) compared to near-term cancers (AUC 0.589, 0.485-0.692), indicating that the performance was not primarily driven by occult disease.

These findings, however, are contingent on the cancer frequency within this population and necessitate further prospective verification before any modifications to imaging schedules.