COMPOSITIONS, METHODS AND KITS FOR DIAGNOSIS OF LUNG CANCER

1 . A method of identifying a status of a pulmonary nodule comprising:

(a) performing an analysis to predict that the pulmonary nodule is not malignant, comprising,

(1) assessing the expression of a plurality of proteins comprising determining the protein level of at least each of ALDOA, FRIL, LG3BP, TSP1, and COIA1, and

(2) calculating a first score based on the protein measurements of step (1);

(b) classifying the risk that the pulmonary nodule of (a) is benign as

(1) statistically significant if the score in step (a)(2) is greater than a first threshold score; or

(2) not statistically significant if the score in step (a)(2) is lesser than the first threshold score;

(c) performing an analysis on the pulmonary nodule of (b)(2), comprising,

(1) assessing the expression of a plurality of proteins comprising determining the protein level of at least each of ALDOA, TSP1, FRIL, KIT, and GGH, and

(2) calculating a second score based on the protein measurements of step (1);

(d) classifying the risk that the pulmonary nodule of (c) is malignant as

(1) statistically significant if the score in step (c)(2) is greater than a second threshold score; or

(2) not statistically significant if the score in step (c)(2) is less than the second threshold score;

thereby identifying the status of the pulmonary nodule as benign or malignant.

2 . The method of claim 1 , wherein the pulmonary nodule has a diameter of less than or equal to 3 cm.

3 . The method of claim 2 , wherein the pulmonary nodule has a diameter of about 0.8 cm to 2.0 cm, inclusive of the endpoints.

4 . The method of claim 1 , wherein the analysis of (a) or (b) is performed on a biological sample selected from the group consisting of tissue, lymph tissue, lymph fluid, blood, plasma, serum, whole blood, urine, saliva, and excreta.

5 . The method of claim 4 , wherein the pulmonary nodule secretes at least one of the proteins of (a)(1) or (c)(1) into a tissue or fluid from which the biological sample is obtained.

6 . The method of claim 4 , wherein the biological sample is obtained from a subject.

7 . The method of claim 6 , wherein the subject is at risk of a lung condition.

8 . The method of claim 7 , wherein the lung condition is cancer.

9 . The method of claim 8 , wherein the cancer is non-small cell lung cancer (NSCLC).

10 . The method of claim 7 , wherein the lung condition is chronic obstructive pulmonary disease, hamartoma, fibroma, neurofibroma, granuloma, sarcoidosis, bacterial infection or fungal infection.

11 . The method of claim 1 , wherein the assessing steps of (a)(1) and/or (c)(1) are performed by mass spectroscopy (MS).

12 . The method of claim 1 , wherein the assessing steps of (a)(1) and/or (c)(1) are performed by liquid chromatography-selected reaction monitoring mass spectrometry (LC-SRM-MS).

13 . The method of claim 1 , wherein the analysis of (a)(2) further comprises determining an interaction between FRIL and COIA1.

14 . The method of claim 1 , wherein the analysis of (c)(2) further comprises determining an interaction between ALDOA and KIT.

15 . The method of claim 1 , wherein the analysis of (a)(1) comprises

generating a plurality of transition ion pairs from the plurality of proteins of (a)(1) and

measuring an abundance of at least one transition ion pair, wherein each transition ion pair consists of a precursor ion m/z and a fragment ion m/z, and wherein said plurality of transition ion pairs comprise at least 3 transitions selected from the group consisting of ALQASALK (SEQ ID NO: 65) transition pair 401.25-617.40, LGGPEAGLGEYLFER (SEQ ID NO: 66) transition pair 804.40-913.40, VEIFYR (SEQ ID NO: 67) transition pair 413.73-598.30, GFLLLASLR (SEQ ID NO: 68) transition pair 495.31-559.40, and AVGLAGTFR (SEQ ID NO: 69) transition pair (446.26-721.40).

16 . The method of claim 1 , wherein the analysis of (c)(1) comprises

generating a plurality of transition ion pairs from the plurality of proteins of (c)(1) and

measuring an abundance of at least one transition ion pair, wherein each transition ion pair consists of a precursor ion m/z and a fragment ion m/z, and wherein said plurality of transition ion pairs comprise at least 3 transitions selected from the group consisting of ALQASALK (SEQ ID NO: 65) transition pair 401.25-617.40, GFLLLASLR (SEQ ID NO: 68) transition pair 495.31-559.40, LGGPEAGLGEYLFER (SEQ ID NO: 66) transition pair 804.40-1083.60, and YVSELHLTR (SEQ ID NO: 70) transition pair.

17 . The method of claim 15 , wherein the generating a plurality of transition ion pairs from the plurality of proteins of (a)(1) comprises fragmenting each protein into at least one peptide.

18 . The method of claim 17 , wherein the fragmenting comprises contacting each protein with a trypsin composition.

19 . The method of claim 17 , wherein the assessing step of (a)(1) are performed by liquid chromatography-selected reaction monitoring mass spectrometry (LC-SRM-MS).

20 . The method of claim 1 , wherein the protein expression assessment of (a)(1) or (c)(1) is normalized with respect to the protein expression one or more proteins selected from the group consisting of PEDF, MASP1, GELS, LUM, C163A and PTPRJ.

21 . The method of claim 20 , wherein the transition ion pair assessment of (a)(1) is normalized with respect to the abundance of one or more transition ion pairs selected from the group consisting of LQSLFDSPDFSK (SEQ ID NO: 71) transition pair 692.34-593.30, TGVITSPDFPNPYPK (SEQ ID NO: 72) transition pair 816.92-258.10, TASDFITK (SEQ ID NO: 73) transition pair 441.73-710.40, SLEDLQLTHNK (SEQ ID NO: 74) transition pair 433.23-499.30, INPASLDK (SEQ ID NO: 75) transition pair 429.24-630.30 and VITEPIPVSDLR (SEQ ID NO: 76) transition pair 669.89-896.50.

22 . The method of claim 1 , wherein the classifying the pulmonary nodule of (b) further comprises determining a sensitivity, a specificity, a negative predictive value or a positive predictive value of the first score.

23 . The method of claim 6 , wherein the pulmonary nodule is classified in (b) as benign and wherein the subject does not receive treatment.

24 . The method of claim 23 , wherein the treatment comprises a pulmonary function test (PFT), pulmonary imaging, a biopsy, a surgery, a chemotherapy, a radiotherapy, or any combination thereof.

25 . The method of claim 24 , where the pulmonary imaging is an x-ray, a chest computed tomography (CT) scan, or a positron emission tomography (PET) scan.

26 . The method of claim 6 , wherein the pulmonary nodule is benign and wherein the subject receives periodic monitoring for between 1 year and 3 years.

27 . The method of claim 26 , wherein the periodic monitoring comprises chest computed tomography.

28 . The method of claim 6 , wherein the pulmonary nodule is malignant and wherein the subject receives treatment according to the standard of care.

29 . The method of claim 28 , wherein the treatment comprises a pulmonary function test (PFT), pulmonary imaging, a biopsy, a surgery, a chemotherapy, a radiotherapy, or any combination thereof.

30 . The method of claim 29 , where the pulmonary imaging is an x-ray, a chest computed tomography (CT) scan, or a positron emission tomography (PET) scan.

31 . The method of claim 16 , wherein the generating a plurality of transition ion pairs from the plurality of proteins of (c)(1) comprises fragmenting each protein into at least one peptide.

32 . The method of claim 31 , wherein the fragmenting comprises contacting each protein with a trypsin composition.

33 . The method of claim 31 , wherein the assessing step of (c)(1) are performed by liquid chromatography-selected reaction monitoring mass spectrometry (LC-SRM-MS).

34 . The method of claim 17 , wherein the at least one peptide is labeled.

35 . The method of claim 34 , wherein the label is an isotopic label.