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Chen Z, Liu X, Shang X, Qi K, Zhang S. The diagnostic value of the combination of carcinoembryonic antigen, squamous cell carcinoma-related antigen, CYFRA 21-1, neuron-specific enolase, tissue polypeptide antigen, and progastrin-releasing peptide in small cell lung cancer discrimination. Int J Biol Markers 2021; 36:36-44. [PMID: 34709098 DOI: 10.1177/17246008211049446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND The diagnostic value of six tumor markers was investigated and the appropriate combinations of those tumor markers to discriminate small cell lung cancer was explored. METHODS Patients suspected with lung cancer (1938) were retrospectively analyzed. Candidate tumor markers from carcinoembryonic antigen (CEA), squamous cell carcinoma-related antigen (SCC), cytokeratin 19 fragment 21-1 (CYFRA 21-1), neuron-specific enolase (NSE), tissue polypeptide antigen (TPA), and progastrin releasing peptide (ProGRP) were selected to construct a logistic regression model. The receiver operating characteristic curve was used for evaluating the diagnostic value of the tumor markers and the predictive model. RESULTS ProGRP had the highest positive rate (72.3%) in diagnosed small cell lung cancer, followed by neuron-specific enolase (68.3%), CYFRA21-1 (50.5%), carcinoembryonic antigen (45.5%), tissue polypeptide antigen (30.7%), and squamous cell carcinoma-related antigen (5.9%). The predictive model for small cell lung cancer discrimination was established, which yielded the highest area under the curve (0.888; 95% confidence interval: 0.846-0.929), with a sensitivity of 71.3%, a specificity of 95.0%, a positive predictive value of 49.0%, and a negative predictive value of 98.0%. CONCLUSIONS Combining tumor markers can improve the efficacy for small cell lung cancer discrimination. A predictive model has been established in small cell lung cancer differential diagnosis with preferable efficacy.
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Affiliation(s)
- Zhimao Chen
- Department of Thoracic Surgery, 26447Peking University First Hospital, Beijing 100034, China
| | - Xiangzheng Liu
- Department of Thoracic Surgery, 26447Peking University First Hospital, Beijing 100034, China
| | - Xueqian Shang
- Department of Thoracic Surgery, 26447Peking University First Hospital, Beijing 100034, China
| | - Kang Qi
- Department of Thoracic Surgery, 26447Peking University First Hospital, Beijing 100034, China
| | - Shijie Zhang
- Department of Thoracic Surgery, 26447Peking University First Hospital, Beijing 100034, China
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Hua Q, Zhu Y, Liu H. Detection of volatile organic compounds in exhaled breath to screen lung cancer: a systematic review. Future Oncol 2018; 14:1647-1662. [PMID: 29939068 DOI: 10.2217/fon-2017-0676] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
To evaluate the clinical value of volatile organic compounds (VOCs) in exhaled breath for lung cancer (LC) screening, a systematic review was performed. Systematic search for studies about exhaled VOCs for LC screening was conducted according to PRISMA. Thirty eight studies with 4873 participants met the criteria for inclusion in this systematic review. Generally speaking, the results suggest that exhaled VOCs have potential to screen LC and more studies are needed in the future.
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Affiliation(s)
- Qingling Hua
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui, PR China
| | - Yanzhe Zhu
- Department of Oncology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, PR China
| | - Hu Liu
- Department of Oncology, The First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, PR China
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3
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Chen Z, Liang R, Guo X, Liang J, Deng Q, Li M, An T, Liu T, Wu Y. Simultaneous quantitation of cytokeratin-19 fragment and carcinoembryonic antigen in human serum via quantum dot-doped nanoparticles. Biosens Bioelectron 2017; 91:60-65. [DOI: 10.1016/j.bios.2016.12.036] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/08/2016] [Accepted: 12/12/2016] [Indexed: 01/11/2023]
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Karimi S, Mohamadnia A, Nadji SA, Yadegarazari R, Khosravi A, Bahrami N, Saidijam M. Expression of two basic mRNA biomarkers in peripheral blood of patients with non-small cell lung cancer detected by real-time rt-PCR, individually and simultaneously. IRANIAN BIOMEDICAL JOURNAL 2015; 19:17-22. [PMID: 25605485 PMCID: PMC4322228 DOI: 10.6091/ibj.1397.2014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction: Although extensive research has been conducted on lung cancer markers, a singular clinically applicable marker has not been found yet. The objective of this study was to evaluate the sensitivity and the specificity of carcinoembryonic antigen (CEA) mRNA and lung-specific X protein (LUNX) mRNA biomarkers in peripheral blood to detect lung cancer individually and simultaneously. Methods: Thirty patients affected by lung cancer and 30 healthy individuals were studied in this research. Three vials of cDNA were made from each sample after taking peripheral blood samples and extracting total RNA. Each sample was examined by the real-time RT-PCR technique. The result from each vial was then compared with the sensitivity of overall marker. Results: The CEA mRNA was positive in 24 out of 30 lung cancer patients. Hence, its sensitivity was determined at 80%, differing significantly from that observed in healthy individuals, where 11 positive cases were seen. The overall sensitivity of this marker was significantly associated with positivity in vials 2 and 3 but not in vial 1. The LUNX mRNA was positive in 21 out of 30 patients, indicating 70% sensitivity. This finding significantly differed from that in healthy individuals. The overall sensitivity of this marker was significantly associated with positivity in vials 1 and 3, but not in vial 2. In 93.3% of the patients, at least one positive marker was observed. Conclusion: The mentioned mRNA could be suggested as sensitive and specific markers in peripheral blood for primary diagnosis of lung cancer.
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Affiliation(s)
- Shirin Karimi
- Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdolreza Mohamadnia
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Dept. of Genetics and Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyed Alireza Nadji
- Virology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Yadegarazari
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Dept. of Genetics and Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Adnan Khosravi
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naghmeh Bahrami
- Iranian Tissue Bank and Research Center Tehran University of Medical Sciences, Tehran, Iran.,Dental Biomaterial Dept. of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Massoud Saidijam
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Dept. of Genetics and Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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5
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Lin G, Zhao H, Liu T, Hou J, Ren Z, Huang W, Dong W, Wu Y. Simultaneous determination of the cytokeratin 19 fragment and carcinoembryonic antigen in human serum by magnetic nanoparticle-based dual-label time-resolved fluoroimmunoassay. RSC Adv 2014. [DOI: 10.1039/c4ra09848j] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
A magnetic nanoparticle-based dual-label TRFIA employing europium and samarium chelate labels for simultaneous determination of CYFRA 21-1 and CEA.
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Affiliation(s)
- Guanfeng Lin
- Institute of Antibody Engineering
- School of Biotechnology
- Southern Medical University
- Guangzhou, China
| | - Hui Zhao
- Department of Human Anatomy
- School of Basic Medical sciences
- Southern Medical University
- Guangzhou, China
| | - Tiancai Liu
- Institute of Antibody Engineering
- School of Biotechnology
- Southern Medical University
- Guangzhou, China
| | - Jingyuan Hou
- Institute of Antibody Engineering
- School of Biotechnology
- Southern Medical University
- Guangzhou, China
| | - Zhiqi Ren
- Institute of Antibody Engineering
- School of Biotechnology
- Southern Medical University
- Guangzhou, China
| | - Wenhua Huang
- Department of Human Anatomy
- School of Basic Medical sciences
- Southern Medical University
- Guangzhou, China
| | - Wenqi Dong
- Department of Biopharmaceutical
- School of Biotechnology
- Southern Medical University
- Guangzhou, China
| | - Yingsong Wu
- Institute of Antibody Engineering
- School of Biotechnology
- Southern Medical University
- Guangzhou, China
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6
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Wei Z, Zeng X, Xu J, Duan X, Yang J, Xie Y. Prognostic value of the pretreatment serum level of cytokeratin fraction 21-1 in undifferentiated nasopharyngeal carcinoma: a study of 332 cases. Head Neck 2013; 36:71-6. [PMID: 23728904 DOI: 10.1002/hed.23261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2013] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Prognostic value of serum cytokeratin fraction 21-1 (CYFRA 21-1) has not been fully validated for nasopharyngeal carcinoma (NPC). METHODS Serum CYFRA 21-1 levels of 332 patients with NPC were measured before treatment, and their association with overall survival (OS), tumor-free survival (TFS), time to local recurrence (TLR), and time to distant recurrence (TDR) was studied. RESULTS Pretreatment serum CYFRA 21-1 level of patients with classification of T1+2 , N0 , stage I+II was significantly lower than that of those with T3+4 , N1+2+3 and III+IV, respectively. Multivariate analysis showed that a high pretreatment serum level of CYFRA 21-1 and T classification were independent predictors of poor OS and TDR. A high pretreatment level of CYFRA 21-1 was an independent predictor of shorter TFS and TLR. CONCLUSION The pretreatment serum level of CYFRA 21-1 would be a reliable biomarker to evaluate the long-term prognosis of patients with undifferentiated NPC.
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Affiliation(s)
- Zhengbo Wei
- Department of Head and Neck Tumor Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China
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Li J, Chen P, Mao CM, Tang XP, Zhu LR. Evaluation of diagnostic value of four tumor markers in bronchoalveolar lavage fluid of peripheral lung cancer. Asia Pac J Clin Oncol 2013; 10:141-8. [PMID: 23551358 DOI: 10.1111/ajco.12066] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2013] [Indexed: 01/23/2023]
Abstract
AIM The diagnostic role of carcinoembryonic antigen (CEA), squamous cell carcinoma (SCC) antigen, Cyfra 21-1 and neuron-specific enolase (NSE) in the bronchoalveolar lavage fluid (BALF) for lung cancer is still controversial. The aim of this study was to evaluate the diagnostic value of these four tumor markers in BALF for peripheral lung cancer. METHODS We measured and compared the levels of CEA, SCC, Cyfra21-1 and NSE in BALF in 42 patients with peripheral lung cancer and 22 patients with benign lung disease. In the patients with peripheral lung cancer, the BAL was separately performed in the bronchus of the tumor-bearing lung and in the corresponding bronchus of the opposite healthy lung. RESULTS The levels of CEA, SCC, Cyfra21-1 and NSE were significantly elevated in BALF from the tumor-bearing lung compared with the opposite healthy lung in the lung cancer patients (P < 0.001) or the benign lung disease patients (P < 0.005). The diagnostic sensitivities of Cyfra21-1 (86 and 76%), with a specificity of 91%, were the highest among the four tumor markers for the tumor-bearing lung versus the opposite healthy lung and benign lung disease. The combination of Cyfra21-1 and CEA increased the sensitivity to 93 and 86 percent, respectively. CONCLUSION The assay of these tumor markers in BALF may be used as a diagnostic tool to complement a cytological examination in the diagnosis of peripheral lung cancer.
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Affiliation(s)
- Jian Li
- Department of Pulmonary Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, China
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Chen Q, Ge F, Cui W, Wang F, Yang Z, Guo Y, Li L, Bremner RM, Lin PP. Lung cancer circulating tumor cells isolated by the EpCAM-independent enrichment strategy correlate with Cytokeratin 19-derived CYFRA21-1 and pathological staging. Clin Chim Acta 2013; 419:57-61. [PMID: 23415723 DOI: 10.1016/j.cca.2013.01.015] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 01/21/2013] [Accepted: 01/24/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cytokeratin 19-derived CYFRA21-1 is an acceptable lung cancer biomarker. However, whether CYFRA21-1 correlates with lung cancer circulating tumor cells (CTCs) remains unclear. METHODS CTCs in 42 lung cancer patients and 10 nonmalignant pulmonary disease patients were isolated by means of an EpCAM-independent enrichment strategy. Correlation of lung cancer CTCs with serum concentration of CYFRA21-1 and pathological staging was investigated. RESULTS Among lung cancer patients in this study, 39% (7/18) of those with normal CYFRA21-1 (≤3.3 ng/ml) and 62% (13/21) of high CYFRA21-1 (>3.3 ng/ml) patients were found to have ≥3 CTCs/7.5 ml blood. The CTCs-positive rate of stage I to IV lung cancer patients was 20% (2/10), 45% (5/11), 54% (6/11) and 70% (7/10), respectively. Comparing M0 vs M1 patients, the CTCs-positive rate was 43% (13/30) and 70% (7/10), respectively. All M1 patients (10/10) had one or more CTCs detected, whereas none of the nonmalignant pulmonary disease patients had detectable CTCs. CONCLUSION Lung cancer CTCs isolated by the EpCAM-independent enrichment approach correlate with CYFRA21-1 and TNM staging. Correlation of CTCs and CYFRA21-1 in lung cancer patients is of potential clinical utility in terms of early diagnosis and predicting prognosis.
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Affiliation(s)
- Qian Chen
- Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Farlow EC, Vercillo MS, Coon JS, Basu S, Kim AW, Faber LP, Warren WH, Bonomi P, Liptay MJ, Borgia JA. A multi-analyte serum test for the detection of non-small cell lung cancer. Br J Cancer 2010; 103:1221-8. [PMID: 20859284 PMCID: PMC2967050 DOI: 10.1038/sj.bjc.6605865] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In this study, we appraised a wide assortment of biomarkers previously shown to have diagnostic or prognostic value for non-small cell lung cancer (NSCLC) with the intent of establishing a multi-analyte serum test capable of identifying patients with lung cancer. METHODS Circulating levels of 47 biomarkers were evaluated against patient cohorts consisting of 90 NSCLC and 43 non-cancer controls using commercial immunoassays. Multivariate statistical methods were used on all biomarkers achieving statistical relevance to define an optimised panel of diagnostic biomarkers for NSCLC. The resulting biomarkers were fashioned into a classification algorithm and validated against serum from a second patient cohort. RESULTS A total of 14 analytes achieved statistical relevance upon evaluation. Multivariate statistical methods then identified a panel of six biomarkers (tumour necrosis factor-α, CYFRA 21-1, interleukin-1ra, matrix metalloproteinase-2, monocyte chemotactic protein-1 and sE-selectin) as being the most efficacious for diagnosing early stage NSCLC. When tested against a second patient cohort, the panel successfully classified 75 of 88 patients. CONCLUSIONS Here, we report the development of a serum algorithm with high specificity for classifying patients with NSCLC against cohorts of various 'high-risk' individuals. A high rate of false positives was observed within the cohort in which patients had non-neoplastic lung nodules, possibly as a consequence of the inflammatory nature of these conditions.
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Affiliation(s)
- E C Farlow
- Department of General Surgery, Rush University Medical Center, 785 Jelke-Southcenter, 1750 W. Harrison Street, Chicago, IL 60612, USA
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Establishment of a multi-analyte serum biomarker panel to identify lymph node metastases in non-small cell lung cancer. J Thorac Oncol 2009; 4:338-47. [PMID: 19190517 DOI: 10.1097/jto.0b013e3181982abf] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION In non-small cell lung cancer (NSCLC), the presence of locoregional lymph node metastases remains the most important prognostic factor and significantly guides treatment regimens. Unfortunately, currently-available noninvasive staging modalities have limited accuracy. The objective of this study was to create a multianalyte blood test capable of discriminating a patient's true (pathologic) nodal status preoperatively. METHODS Pretreatment serum specimens collected from 107 NSCLC patients with localized disease were screened with 47 biomarkers implicated in disease presence or progression. Multivariate statistical algorithms were then used to identify the optimal combination of biomarkers for accurately discerning each patient's nodal status. RESULTS We identified 15 candidate biomarkers that met our criteria for statistical relevance in discerning a patient's preoperative nodal status. A 'random forest' classification algorithm was used with these parameters to define a 6-analyte panel, consisting of macrophage inflammatory protein-1alpha, carcinoembryonic antigen, stem cell factor, tumor necrosis factor-receptor I, interferon-gamma, and tumor necrosis factor-alpha, that was the optimum combination of biomarkers for identifying a patient's pathologic nodal status. A Classification and Regression Tree analysis was then created with this panel that was capable of correctly classifying 88% of the patients tested, relative to the pathologic assessments. This value is in contrast to our observed 85% classification rate using conventional clinical methods. CONCLUSIONS This study establishes a serum biomarker panel with efficacy in discerning preoperative nodal status. With further validation, this blood test may be useful for assessing nodal status (including occult disease) in NSCLC patients facing tumor resection therapy.
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Hillas G, Moschos C, Dimakou K, Vlastos F, Avgeropoulou S, Christakopoulou I, Rasidakis A, Bakakos P. Carcinoembryonic antigen, neuron-specific enolase and cytokeratin fragment 19 (CYFRA 21-1) levels in induced sputum of lung cancer patients. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 68:542-7. [PMID: 19378425 DOI: 10.1080/00365510701883172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The diagnosis of lung cancer is usually based on the histological and cytological examination of material obtained by bronchoscopy. Tumour markers in serum are of little use as a diagnostic tool for lung cancer. We hypothesized that induced sputum could be a suitable material for measuring tumour markers and, accordingly, attempted to evaluate the diagnostic value of such measurements in lung cancer. Induced sputum is minimally invasive and readily obtainable. MATERIAL AND METHODS Fifty patients with lung cancer and 24 subjects with chronic obstructive pulmonary disease (COPD) were included in the study. CEA, NSE and CYFRA 21-1 levels in serum and induced sputum were measured by immunoradiometric assays. RESULTS Serum and sputum CEA, serum and sputum NSE and serum CYFRA 21-1 did not differ significantly between lung cancer and COPD patients. Sputum CYFRA 21-1 was 7 times greater in the lung cancer group than in the COPD group. This finding was true in both small cell (SCLC) and non-small cell (NSCLC) lung cancer. The sensitivity, specificity, positive and negative predictive values were 86, 75, 88 and 72%, respectively. CONCLUSION Of tumour markers in induced sputum, sputum CYFRA 21-1 offered the best predictive values, although not sufficiently satisfactory to suggest its routine use in lung cancer diagnosis.
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Affiliation(s)
- G Hillas
- Department of Respiratory and Critical Care Medicine, "Sotiria" Chest Diseases Hospital, Athens, Greece
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Gruber C, Hatz R, Reinmiedl J, Nagel D, Stieber P. CEA, CYFRA 21-1, NSE, and ProGRP in the diagnosis of lung cancer: a multivariate approach / CEA, CYFRA 21-1, NSE und ProGRP in der Diagnostik des Lungenkarzinoms: eine multivariate Analyse. ACTA ACUST UNITED AC 2008. [DOI: 10.1515/jlm.2008.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
We retrospectively studied the single and combined diagnostic value of carcinoembryonic antigen (CEA), cytokeratin fragment 19 (CYFRA 21-1), neuron specific enolase (NSE) and pro-gastrin-releasing peptide (ProGRP), which were routinely analysed in patients with lung tumours of unknown origin at the time of admission to hospital. Inclusion criteria were the determination of CEA (AxSYM/Abbott), CYFRA 21-1 (ElecSys/Roche) and NSE (Kryptor/Brahms). We examined 1747 patients, where 1325 suffered from lung cancer (LC; small cell lung cancer, SCLC: n=194; non-small cell lung cancer, NSCLC: n=1015; others: n=116), 318 from benign lung diseases and 104 from lung metastases due to another primary malignancy. As ProGRP (ELISA ALSI/IBL) became available only recently, there are less data points of this marker. In total, 99.8% of LC patients released at least one of the four biomarkers (defined as values exceeding the median of healthy controls), and for the discrimination between benign disease (BD) and malignant lung disease each marker reached 100% tumour specificity at high levels (CEA: 20 ng/mL; CYFRA 21–1: 40 ng/mL; NSE: 45 ng/mL; ProGRP: 250 pg/mL). At a specificity of >99%, ProGRP reached the highest diagnostic efficacy for SCLC with 57% true positive results, CEA had the highest capacity (17%) to detect malignant lung tumours in general and adenocarcinomas of the lung with 29%. CYFRA 21-1 was dominant for squamous cell carcinomas (12%). Combining the four markers leads with the prerequisite of high specificity (>99%) to 50% true positives for malignant lung tumours, 44% for NSCLC, 36% for squamous cell carcinomas, 53% for adenocarcinomas, and 78% for SCLC, respectively. In cases of lung tumours of unknown origin, the combined use of CEA, CYFRA 21-1, NSE and ProGRP is useful for the differentiation between benign and primary or secondary malignant disease and suggests the assignment to histological subtypes.
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Affiliation(s)
- Christine Gruber
- Institute of Clinical Chemistry, University of Munich, Munich, Germany
| | - Rudolf Hatz
- Department of Surgery, University of Munich, Munich, Germany
| | | | - Dorothea Nagel
- Institute of Clinical Chemistry, University of Munich, Munich, Germany
| | - Petra Stieber
- Institute of Clinical Chemistry, University of Munich, Munich, Germany
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Serum Proteomic Profiling of Lung Cancer in High-Risk Groups and Determination of Clinical Outcomes. J Thorac Oncol 2008; 3:840-50. [DOI: 10.1097/jto.0b013e31817e464a] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
The expression of biomarkers by lung cancers is useful in the diagnosis and clinical management of patients with lung cancer. Biomarkers provide insight into histogenesis, interrelationships, and biological behavior of lung tumors. This chapter presents data on lung cancer detection, involving some of the most studied and interesting lung cancer biomarkers to date-CYFRA 21-1, NSE, ProGRP, SCC, CEA, Tumor M2-PK, as well as markers in clinical application such as CRP, LDH, tumor-suppressor genes and oncogenes, CA125, CgA, NCAM, and TPA. Biomarker profiles in combination with fuzzy logic techniques have also been addressed. Serum markers used alone or in combination with other indices might play an important role in monitoring response to therapy in early detection of tumor reactivation in new treatment strategies as well as in secondary prevention.
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Affiliation(s)
- Joachim Schneider
- Institut und Poliklinik für Arbeits- und Sozialmedizin der Justus-Liebig Universität, Aulweg 129/III, D-35385 Giessen, Germany
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Jankowska R, Witkowska D, Porebska I, Kuropatwa M, Kurowska E, Gorczyca WA. Serum Antibodies to Retinal Antigens in Lung Cancer and Sarcoidosis. Pathobiology 2004; 71:323-8. [PMID: 15627843 DOI: 10.1159/000081728] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2004] [Accepted: 07/30/2004] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Autoantibodies to various neuronal proteins frequently accompany lung cancer and their appearance may precede cancer symptoms. In this study we examined which retinal antigens (RAs) are recognized by sera of patients with lung cancer and whether the occurrence of serum antibodies to particular RAs is characteristic for cancer in comparison with a noncancer lung disease. METHODS Sera of 72 patients with non-small-cell lung cancer (NSCLC), 29 with small-cell lung cancer (SCLC), 27 with sarcoidosis (S), and sera of 32 healthy donors were examined in immunoblotting using retinal extracts and purified RAs as antigens. RESULTS 69.0% of SCLC, 45.8% of NSCLC, and 44.4% of S sera displayed anti-RAs reactivity. Significantly less (p < 0.05; chi(2) test) percent of healthy control sera reacted with RAs. Lung cancer sera recognized mainly 46-, 56-, and 36-kD and to a smaller extent also 96-, 72-, 43-, and 26-kD proteins. Most of them were recognized with about 2-fold lower frequencies by S and control sera. Only lung cancer sera contained very high-titer antibodies to 46- and 26-kD RAs, identified as alpha-enolase and recoverin, respectively. CONCLUSION Antibodies to RAs occur more frequently and in higher titers in lung cancer (especially SCLC) than in sarcoidosis or control sera. Although antibodies to retinal alpha-enolase, recoverin and other RAs are present mainly or exclusively in lung cancer sera, none of them seems to be a specific marker of a particular disease.
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Affiliation(s)
- R Jankowska
- Department of Pulmonology, Wroclaw Medical University, Wrocław, Poland
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Kalomenidis I, Dimakou K, Kolintza A, Vlami K, Papadakis M, Sotiropoulou C, Orphanidou D, Roussos C, Papiris S. Sputum carcinoembryonic antigen, neuron-specific enolase and cytokeratin fragment 19 levels in lung cancer diagnosis. Respirology 2004; 9:54-9. [PMID: 14982602 DOI: 10.1111/j.1440-1843.2003.00536.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of the present study was to examine the impact of sputum carcinoembryonic antigen (CEA), neuron-specific enolase (NSE) and cytokeratin fragment 19 (CYFRA 21-1) levels in lung cancer diagnosis and to compare the diagnostic usefulness of sputum assays with that of serum assays. METHODOLOGY Forty-seven patients with lung cancer and 62 with benign lung disease were studied. Tumour marker levels in sputum (sp.) and serum (ser) were measured by immunoradiometric assays. RESULTS Sputum and serum tumour marker levels were significantly higher in lung cancer than in benign disease. When the specificity was 95%, the sensitivity was 57%, 43%, 36%, 30%, 28% and 19%, for spCEA, serCYFRA 21-1, spCYFRA 21-1, serCEA, serNSE, and spNSE, respectively. Bayesian analysis showed that the best predictive values correspond to spCEA and serCYFRA 21-1. The maximum overall gain was obtained in pretest probability of 0.35 for both spCEA and serCYFRA 21-1, with predictive values of 84% and 80% for spCEA and serCYFRA 21-1, respectively. CONCLUSION Sputum tumour marker levels were no more useful than the serum levels in lung cancer diagnosis. SpCEA offered the best predictive values but these were still not sufficiently satisfactory for spCEA to be proposed for routine use.
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Affiliation(s)
- Ioannis Kalomenidis
- Department of Critical Care and Pulmonary Services, Athens Medical School, Evangelismos Hospital, Athens, Greece.
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Etzioni R, Urban N, Ramsey S, McIntosh M, Schwartz S, Reid B, Radich J, Anderson G, Hartwell L. The case for early detection. Nat Rev Cancer 2003; 3:243-52. [PMID: 12671663 DOI: 10.1038/nrc1041] [Citation(s) in RCA: 755] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Early detection represents one of the most promising approaches to reducing the growing cancer burden. It already has a key role in the management of cervical and breast cancer, and is likely to become more important in the control of colorectal, prostate and lung cancer. Early-detection research has recently been revitalized by the advent of novel molecular technologies that can identify cellular changes at the level of the genome or proteome, but how can we harness these new technologies to develop effective and practical screening tests?
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Affiliation(s)
- Ruth Etzioni
- Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, Washington 98109, USA.
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Abstract
Lung tumor markers fall into several categories including oncofetal proteins, structural proteins and their fragments, enzymes, membrane antigens, peptide and non-peptide hormones. Cytokeratins (CK) are well known structural proteins whose degradation gives rise to soluble fragments, measurable in the blood of patients and capable of cancer marking. Among them, Tissue Polypeptide Antigen (TPA), Tissue Polypeptide-Specific Antigen (TPS) and Cytokeratin-19-Fragments (Cyfra 21-1) are the most studied CK fragments' complexes. This article will review biological characteristics and clinical properties of these substances, emphasizing as their concentration in the peripheral blood might reflect the mass of tumor, the rate of cancer cell lysis, and other potentially unfavorable tumor characteristics. Assaying the concentration of CK fragments in the blood is an easy and effective way to assess lung cancer and monitor its clinical evolution.
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Affiliation(s)
- G Buccheri
- Divisione di Pneumologia, Ospedale 'S. Croce e Carle', I-12100, Cuneo, Italy.
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Cioffi M, Vietri MT, Gazzerro P, Magnetta R, D'Auria A, Durante A, Nola E, Puca GA, Molinari AM. Serum anti-p53 antibodies in lung cancer: comparison with established tumor markers. Lung Cancer 2001; 33:163-9. [PMID: 11551411 DOI: 10.1016/s0169-5002(01)00201-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
As reported earlier, p53 antibodies are detected in the sera of patients with different types of cancer, including lung cancer. In contrast, in the serum of healthy subjects the presence of anti-p53 antibodies is extremely rare. We collected the venous blood samples of 109 patients affected with lung cancer (LC): 57 patients (46 M, 11 F) with non-small-cell carcinoma (NSCLC), 52 others (40 M, 12 F) with small-cell carcinoma (SCLC). Serum p53 antibodies were assayed using ELISA method and all positive sera were confirmed by Western-blot method. In addition, using IRMA methods we assayed serum CEA, TPA, CYFRA21-1 and NSE. Serum p53Ab are detectable (p53Ab-positive) in 35/109 (32.1%) patients with lung cancer. About 17/57 (29.8%) patients affected with NSCLC and 18/52 (34.6%) with SCLC were p53Ab-positive. CEA, TPA, CYFRA21-1 and NSE sensitivity in LC patients (NSCLC+SCLC) is 50.5%, 58.7%, 42.2%, 35.8%, respectively. The lower sensitivity (32.1%) of serum p53Ab is connected with the higher specificity and diagnostic accuracy (100% and 69%, respectively). Out of 35 patients p53Ab-positive, five (14.3%) exhibit only serum p53Ab, while serum values of the established tumor markers were lower than cut-off. Serum p53Ab assessment is a simple and a low-cost assay with a good specificity and diagnostic accuracy that in LC patients can be used at least in association with established tumor markers.
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Affiliation(s)
- M Cioffi
- Istituto di Patologia Generale e Oncologia, Facoltà di Medicina e Chirurgia Seconda Università degli Studi di Napoli, Via S. Andrea delle Dame 2-80138, Napoli, Italy.
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Seemann MD, Beinert T, Fürst H, Fink U. An evaluation of the tumour markers, carcinoembryonic antigen (CEA), cytokeratin marker (CYFRA 21-1) and neuron-specific enolase (NSE) in the differentiation of malignant from benign solitary pulmonary lesions. Lung Cancer 1999; 26:149-55. [PMID: 10598925 DOI: 10.1016/s0169-5002(99)00084-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this prospective study was to assess the diagnostic value of the tumour markers carcinoembryonic antigen (CEA), cytokeratin 19 fragment marker (CYFRA 21-1) and neuron-specific enolase (NSE) in the differentiation of malignant (MSPLs) from benign solitary pulmonary lesions (BSPLs). METHODS Solitary pulmonary lesions (SPLs) were diagnosed using plain radiography and spiral computed tomography (SCT) and then completely removed by surgery in 104 consecutive patients (MSPLs; n = 81, BSPLs; n = 23). The serum concentrations of the tumour markers were determined 1-3 days prior to surgery by ELISA for CEA and CYFRA 21-1 and by IRMA for NSE using commercially available assay kits. The cut-off values were set at 3 ng/ml (for non-smokers) and 5 ng/ml (for smokers) for CEA, at 3.3 ng/ml for CYFRA 21-1 and at 12.5 ng/ml for NSE. RESULTS MSPLs were identified with a sensitivity between 13.6 and 45.7%, a specificity between 87.0 and 100% and an accuracy between 32.7 and 54.8%. Using the tumour markers alone, the highest sensitivity (27.2%) and accuracy (40.4%) was found with CEA, the highest specificity (100%) with CYFRA 21-1 and with NSE. Primary lung cancers (n = 39) were identified with a sensitivity between 17.9 and 61.5%, a specificity between 87.0 and 100% and an accuracy between 48.4 and 71.0%. Using the tumour markers alone, the highest sensitivity (35.9%) and accuracy (59.7%) was found with CYFRA 21-1, the highest specificity (100%) with CYFRA 21-1 and with NSE. The combination of all three tumour markers resulted in a greater sensitivity and greater diagnostic accuracy but a loss in specificity compared with CYFRA 21-1 and NSE. CONCLUSION The use of the tumour markers alone or in combination showed a low sensitivity and low accuracy for the diagnostic differentiation of MSPLs from BSPLs and primary lung cancers from BSPLs. However, both CYFRA 21-1 and NSE exhibited a specificity of 100% and may be useful complements to standard clinical imaging methods.
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Affiliation(s)
- M D Seemann
- Department of Diagnostic Radiology, Klinikum Grosshadern, Ludwig-Maximilians University, Munich, Germany.
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Baughman RP, Pina EM. Role of bronchoscopy in lung cancer research. Clin Chest Med 1999; 20:191-9. [PMID: 10205725 DOI: 10.1016/s0272-5231(05)70134-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The use of bronchoscopy for research into lung cancer is mostly limited by the imagination of the investigator. This technique allows the scientist direct access to tissue in a minimally invasive manner. We have discussed some of the applications of this technique in better understanding lung cancer. As we move onward in the areas of diagnosis and treatment of lung cancer, the bronchoscope will remain an important research tool.
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Affiliation(s)
- R P Baughman
- Department of Pulmonary and Critical Care Medicine, University of Cincinnati Medical Center, Ohio, USA
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