Diagnostic accuracy of ELISA for detecting serum Midkine in cancer patients

Large-scale proximity extension assay reveals CSF midkine and DOPA decarboxylase as supportive diagnostic biomarkers for Parkinson's disease

BACKGROUND

There is a need for biomarkers to support an accurate diagnosis of Parkinson's disease (PD). Cerebrospinal fluid (CSF) has been a successful biofluid for finding neurodegenerative biomarkers, and modern highly sensitive multiplexing methods offer the possibility to perform discovery studies. Using a large-scale multiplex proximity extension assay (PEA) approach, we aimed to discover novel diagnostic protein biomarkers allowing accurate discrimination of PD from both controls and atypical Parkinsonian disorders (APD).

METHODS

CSF from patients with PD, corticobasal syndrome (CBS), progressive supranuclear palsy (PSP), multiple system atrophy and controls, were analysed with Olink PEA panels. Three cohorts were used in this study, comprising 192, 88 and 36 cases, respectively. All samples were run on the Cardiovascular II, Oncology II and Metabolism PEA panels.

RESULTS

Our analysis revealed that 26 and 39 proteins were differentially expressed in the CSF of test and validation PD cohorts, respectively, compared to controls. Among them, 6 proteins were changed in both cohorts. Midkine (MK) was increased in PD with the strongest effect size and results were validated with ELISA. Another most increased protein in PD, DOPA decarboxylase (DDC), which catalyses the decarboxylation of DOPA (L-3,4-dihydroxyphenylalanine) to dopamine, was strongly correlated with dopaminergic treatment. Moreover, Kallikrein 10 was specifically changed in APD compared with both PD and controls, but unchanged between PD and controls. Wnt inhibitory factor 1 was consistently downregulated in CBS and PSP patients in two independent cohorts.

CONCLUSIONS

Using the large-scale PEA approach, we have identified potential novel PD diagnostic biomarkers, most notably MK and DDC, in the CSF of PD patients.

Association between serum midkine levels and tumor size in Indonesian hepatocellular carcinoma patients: a cross-sectional study

Background: The incidence of liver cancer is increased worldwide with 75%–85% are diagnosed as hepatocellular carcinoma (HCC). Current practice has low sensitivity limitations to diagnose the early stages of HCC, thus urging the need for a biomarker with higher sensitivity to detect HCC, specifically in the early stage. This study aimed to determine the association between Midkine levels and progressiveness of hepatocellular carcinoma (HCC), according to tumor size, Barcelona Clinic Liver Cancer (BCLC), and presence of portal venous thrombosis.

Methods: This cross-sectional study involved 100 patients in Adam Malik General Hospital diagnosed with HCC, collected with a consecutive sampling method, whose diagnosis were confirmed by findings of hypervascular on arterial phase imaging and portal vein or delayed phase washout triple-phase CT Scan. Samples are later categorized according to Barcelona Clinic Liver Cancer (BCLC) stages, tumor size, and presence of portal venous thrombosis. Blood samples were drawn to measure serum Midkine using ELISA. Kruskal-Wallis and Mann-Whitney U tests were conducted to determine the difference of Midkine levels based on tumor size, BCLC staging, and presence of portal venous thrombosis.

Results: Serum Midkine level shows a significant difference over tumor size (p=0.014), no significant difference found compared to BCLC stages and presence of portal venous thrombosis.

Conclusion: Serum Midkine levels are associated with the tumor size of HCC, thus helping physicians determine treatment plans.

Midkine (MDK) growth factor: a key player in cancer progression and a promising therapeutic target

Midkine is a heparin-binding growth factor, originally reported as the product of a retinoic acid-responsive gene during embryogenesis, but currently viewed as a multifaceted factor contributing to both normal tissue homeostasis and disease development. Midkine is abnormally expressed at high levels in various human malignancies and acts as a mediator for the acquisition of critical hallmarks of cancer, including cell growth, survival, metastasis, migration, and angiogenesis. Several studies have investigated the role of midkine as a cancer biomarker for the detection, prognosis, and management of cancer, as well as for monitoring the response to cancer treatment. Moreover, several efforts are also being made to elucidate its underlying mechanisms in therapeutic resistance and immunomodulation within the tumor microenvironment. We hereby summarize the current knowledge on midkine expression and function in cancer development and progression, and highlight its promising potential as a cancer biomarker and as a future therapeutic target in personalized cancer medicine.

Diagnostic accuracy of midkine on hepatocellular carcinoma: A meta-analysis

OBJECTIVE

To evaluate the dependability and accuracy of midkine (MK) in the diagnosis of hepatocellular carcinoma (HCC).

METHODS

PubMed, EMBASE, Web of Science, China Biology Medicine disc and grey literature sources were searched from the date of database inception to January 2019. Two authors (B-H.Z. and B.L.) independently extracted the data and evaluated the study quality using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The sensitivity, specificity, positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were estimated using a bivariate model. Moreover, hierarchical summary receiver operating characteristic curves were generated. The diagnostic odds ratio (DOR) and area under the curve (AUC) were pooled using a univariate model.

RESULTS

Nine articles (11 studies) were included (1941 participants). The bivariate analysis revealed that the sensitivity and specificity of MK for HCC diagnosis were 0.85 (95% CI 0.78-0.91) and 0.83 (95% CI 0.76-0.88), respectively. We also found a LR+ of 5.05 (95% CI 3.33-7.40), a LR- of 0.18 (95% CI 0.11-0.28), a DOR of 31.74 (95% CI 13.98-72.09) and an AUC of 0.91 (95% CI 0.84-0.99). Subgroup analyses showed that MK provided the best efficiency for HCC diagnosis when the cutoff value was greater than 0.5 ng/mL.

CONCLUSIONS

MK has an excellent diagnostic value for hepatocellular carcinoma.

Diagnostic impact of high serum midkine level in patients with gastric cancer

AIM

We evaluated the diagnostic impact of serum midkine (s-MK) levels in patients with gastric cancer using a monoclonal antibody enzyme-linked immunosorbent assay system (ELISA) to detect s-MK levels.

METHODS

Serum samples were obtained from 131 patients with gastric cancer including stage I (n = 71), stage II (n = 28), stage III (n = 16), and stage IV (n = 16) before surgery. Serum samples were analyzed using ELISA to detect soluble midkine. A cut-off value was fixed at 421 pg/mL, and the sample divided into two groups: a high s-MK group and a low s-MK group. Clinicopathological factors and prognosis were compared between these two groups using univariate and multivariate analyses. Comparison of two groups was analyzed by Fisher's exact probability test. Statistical significance was considered at P < 0.05.

RESULTS

High s-MK was significantly associated with high carcinoembryonic antigen (CEA) (P < 0.01). Positive rate of s-MK was higher than the positive rates of CEA in patients with stage I/II gastric cancer. Combination with CEA + CA19-9 + s-MK increased the positive rates of patients with stage I/II gastric cancer. No other clinicopathological factors were associated with s-MK. Although the high s-MK group showed worse overall survival than the low s-MK group, the difference was not statistically significant.

CONCLUSION

s-MK level is increased even during early-stage gastric cancer. Combined with s-MK, the positive rate of CEA + CA19-9 was increased in patients with stage I/II gastric cancer.

Quantum Dot Based Nano-Biosensors for Detection of Circulating Cell Free miRNAs in Lung Carcinogenesis: From Biology to Clinical Translation

Lung cancer is the most frequently occurring malignancy and the leading cause of cancer-related death for men in our country. The only recommended screening method is clinic based low-dose computed tomography (also called a low-dose CT scan, or LDCT). However, the effect of LDCT on overall mortality observed in lung cancer patients is not statistically significant. Over-diagnosis, excessive cost, risks associated with radiation exposure, false positive results and delay in the commencement of the treatment procedure questions the use of LDCT as a reliable technique for population-based screening. Therefore, identification of minimal-invasive biomarkers able to detect malignancies at an early stage might be useful to reduce the disease burden. Circulating nucleic acids are emerging as important source of information for several chronic pathologies including lung cancer. Of these, circulating cell free miRNAs are reported to be closely associated with the clinical outcome of lung cancer patients. Smaller size, sequence homology between species, low concentration and stability are some of the major challenges involved in characterization and specific detection of miRNAs. To circumvent these problems, synthesis of a quantum dot based nano-biosensor might assist in sensitive, specific and cost-effective detection of differentially regulated miRNAs. The wide excitation and narrow emission spectra of these nanoparticles result in excellent fluorescent quantum yields with a broader color spectrum which make them ideal bio-entities for fluorescence resonance energy transfer (FRET) based detection for sequential or simultaneous study of multiple targets. In addition, photo-resistance and higher stability of these nanoparticles allows extensive exposure and offer state-of-the art sensitivity for miRNA targeting. A major obstacle for integrating QDs into clinical application is the QD-associated toxicity. However, the use of non-toxic shells along with surface modification not only overcomes the toxicity issues, but also increases the ability of QDs to quickly detect circulating cell free miRNAs in a non-invasive mode. The present review illustrates the importance of circulating miRNAs in lung cancer diagnosis and highlights the translational prospects of developing QD-based nano-biosensor for rapid early disease detection.

Systematic analysis of gene expression alterations and clinical outcomes of STAT3 in cancer

Accumulated studies have provided controversial evidences of prognostic value for signal transducer and activator of transcription proteins 3 (STAT3) in cancers. To address this inconsistency, we performed a systematic analysis to determine whether STAT3 can serve as a prognostic marker in human cancers. STAT3 expression was assessed using Oncomine analysis. cBioPortal, Kaplan-Meier Plotter, and Prognoscan were performed to identify the prognostic roles of STAT3 in human cancers. The copy number alteration, mutation, interactive analysis, and visualize the altered networks were performed by cBioPortal. We found that STAT3 was more frequently overexpressed in lung, ovarian, gastric, blood and brain cancers than their normal tissues and its expression might be negatively related with the prognosis. In addition, STAT3 mutation mainly occurred in uterine cancer and existed in a hotspot in SH2 domain. Those findings suggest that STAT3 might serve as a diagnostic and therapeutic target for certain types of cancer, such as lung, ovarian, gastric, blood and brain cancers. However, future research is required to validate our findings and thus promote the clinical utility of STAT3 in those cancers prognosis evaluation.