Clinical Significance of CYFRA21-1, AFP, CA-153, CEA, and CA-199 in the Diagnosis of Lung Cancer Ocular Metastasis in Hypertension Population

Reference intervals of Cyfra21-1 and CEA in healthy adult Han Chinese population

Objective

This study aimed to establish the reference intervals of Cyfra21-1 and CEA for the local screening populations using a chemiluminescence method.

Methods

A total of 4845 healthy adults and 190 lung cancer patients were included from the First Hospital of Hebei Medical University. The levels of Cyfra21-1 and CEA were measured to establish the local reference intervals.

Results

The upper limit reference intervals for Cyfra21-1 and CEA were determined as 3.19 ng/ml and 3.13 ng/ml, respectively. Notably, both Cyfra21-1 and CEA levels were found to be higher in males than in females. Additionally, both biomarkers showed an increasing trend with age.In terms of diagnostic efficacy, the receiver operating characteristic (ROC) curve areas for Cyfra21-1, CEA, and their combination in lung cancer were 0.86, 0.73, and 0.91, respectively.

Conclusion

Our study revealed that the reference intervals of Cyfra21-1 and CEA in the local population differed from the established reference intervals. Furthermore, both biomarkers exhibited gender-dependent variations and demonstrated a positive correlation with age. Combining the two biomarkers showed potential for improving the diagnosis rate of lung cancer.

Development and validation of a nomogram based on preoperative variables for predicting recurrence-free survival in stage IA lung adenocarcinoma

BACKGROUND

This study aimed to establish a nomogram for predicting risk of recurrence and provide a model for decision-making between lobectomy and sublobar resection in patients with stage IA lung adenocarcinoma.

METHODS

Patients diagnosed with stage IA lung adenocarcinoma (LUAD) between December 2010 and October 2018 from Cancer Hospital Chinese Academy of Medical Sciences were included. Patients were randomly assigned to training and validation cohorts, accounting for 70% and 30% of the total cases, respectively. We collected laboratory variables before surgery. Univariate and multivariate analyses were performed in the training cohort to identify variables significantly associated with recurrence-free survival (RFS) which were subsequently used to construct a nomogram. Validation was conducted in both cohorts. A receiver operating characteristic curve was used to determine the optional cutoff values of the scores calculated from the nomogram. Patients were then divided into low- and high-risk groups. Survival was performed to determine if the nomogram could guide the operation method.

RESULTS

A total of 543 patients were included in this study. Gender, albumin level, carcinoembryonic antigen level and cytokeratin-19-fragment level were included in the nomogram. In both cohorts, the nomogram stratified the patients into high- and low-risk groups in terms of RFS. In particular, there was a significant difference in RFS between lobectomy and sublobar resection in the high-risk group.

CONCLUSIONS

Gender, albumin level, carcinoembryonic antigen level and cytokeratin-19-fragment level are valuable markers in predicting recurrence and can guide surgical practice in patients with stage IA LUAD.

The role of N-glycosylation modification in the pathogenesis of liver cancer

N-glycosylation is one of the most common types of protein modifications and it plays a vital role in normal physiological processes. However, aberrant N-glycan modifications are closely associated with the pathogenesis of diverse diseases, including processes such as malignant transformation and tumor progression. It is known that the N-glycan conformation of the associated glycoproteins is altered during different stages of hepatocarcinogenesis. Characterizing the heterogeneity and biological functions of glycans in liver cancer patients will facilitate a deeper understanding of the molecular mechanisms of liver injury and hepatocarcinogenesis. In this article, we review the role of N-glycosylation in hepatocarcinogenesis, focusing on epithelial-mesenchymal transition, extracellular matrix changes, and tumor microenvironment formation. We highlight the role of N-glycosylation in the pathogenesis of liver cancer and its potential applications in the treatment or diagnosis of liver cancer.

Status quo of Extracellular Vesicle isolation and detection methods for clinical utility

Extracellular vesicles (EVs) are nano-sized particles that hold tremendous potential in the clinical space, as their biomolecular profiles hold a key to non-invasive liquid biopsy for cancer diagnosis and prognosis. EVs are present in most bodily fluids, hence are easily obtainable from patients, advantageous to that of traditional, invasive tissue biopsies and imaging techniques. However, there are certain constraints that hinder clinical use of EVs. The translation of EV biomarkers from "bench-to-bedside" is encumbered by the methods of EV isolation and subsequent biomarker detection currently implemented in laboratories. Although current isolation and detection methods are effective, they lack practicality, with their requirement for high bodily fluid volumes, low equipment availability, slow turnaround times and high costs. The high demand for techniques that overcome these limitations has resulted in significant advancements in nanotechnological devices. These devices are designed to integrate EV isolation and biomarker detection into a one-step method of direct EV detection from bodily fluids. This provides promise for the acceleration of EVs into current clinical standards. This review highlights the importance of EVs as cancer biomarkers, the methodological obstacles currently faced in clinical studies and how novel nanodevices could advance clinical translation.

Value of CT Radiomics and Clinical Features in Predicting Bone Metastases in Patients with NSCLC

Objective

To explore the CT radiomic features and clinical imaging features of the primary tumor in patients with nonsmall cell lung cancer (NSCLC) before treatment and their predictive value for the occurrence of bone metastases.

Methods

From June 2017 to June 2021, 195 patients with NSCLC who were pathologically diagnosed without any treatment in the Cancer Hospital Affiliated to Hainan Medical College were retrospectively analyzed, and they were divided into a bone metastasis group and a nonbone metastasis group. The relationship between clinical imaging features and bone metastasis in patients was analyzed by the t-test, rank sum test, and χ 2 test. At the same time, ITK software was used to extract the radiomic characteristics of the primary tumor of the patients, and the patients were randomly divided into a training group and a validation group in a ratio of 7 : 3. The training model was validated in the validation group, and the performance of the model for predicting bone metastases in NSCLC patients was verified by the ROC curve, and a multivariate logistic regression prediction model was established based on the omics parameters extracted from the best prediction model combined with clinical image features.

Results

Seven features were screened from the primary tumor by LASSO to establish a model for predicting metastasis. The area under the curve was 0.82 and 0.73 in the training and validation sets. The best omics signature and univariate analysis suggested clinical imaging factors (P < 0.05) associated with bone metastases were included in multivariate binary logistic analysis to obtain clinical characteristics of the primary tumor such as gender (OR = 0.141, 95% CI: 0.022-0.919, P = 0.04), increased Cyfra21-1 (OR = 0.12, 95% CI: 0.018-0.782, P = 0.027), Fe content in blood (OR = 0.774, 95% CI: 0.626-0.958, P = 0.018), CT signs such as lesion homogeneity (OR = 0.052, 95% CI: 0.006-0.419, P = 0.006), pleural indentation sign (OR = 0.007, 95% CI: 0.001-0.696, P = 0.034), and omics characteristics glszm_Small Area High Gray Level Emphasis (OR = 0.016, 95% CI: 0.001-0.286, P = 0.005) were independent risk factors for bone metastasis in patients.

Conclusion

The prediction model established based on radiomics and clinical imaging features has high predictive performance for the occurrence of bone metastasis in NSCLC patients.

Efficacy of autoantibodies combined with tumor markers in the detection of lung cancer

BACKGROUND

The purpose of this study was to explore the detection value of seven autoantibodies (TAAbs): p53, PGP9.5, SOX2, GBU4-5, MAGE A1, CAGE, and GAGE7 and three tumor markers: CYFRA21-1, NSE, and SCCA in the diagnosis of lung cancer.

METHODS

ELISA was used to detect the levels of the TAAbs, and chemiluminescence immunoassay was used to test the levels of the tumor markers. The diagnostic efficacy of the TAAbs combined with the tumor markers for lung cancer was evaluated by receiver operating characteristic (ROC) curves.

RESULTS

The positive rate of the combined detection of seven TAAbs and three tumor markers in lung cancer (37.8%) was higher than that in other three groups. The positive rates of SOX2, GAGE7, MAGE A1, CAGE, CYFRA21-1, and SCCA had differences among the four groups. Compared with the benign lung disease group, only GAGE7, CYFRA21-1, and SCCA differed among the groups. The combined sensitivity of the TAAbs was 29.07% (AUC, 0.594), the combined sensitivity of all the markers was 37.76% (AUC, 0.660 [p < 0.05]), and Youden's index was 0.196. In the lung cancer group, CYFRA21-1 had a significant difference in age and sex, and SOX2, MAGE A1, CYFRA21-1, NSE, and SCCA were significantly different in pathological type and TNM. In contrast, p53 and GBU4-5 showed no significant differences in age, sex, pathological type, and TNM.

CONCLUSIONS

The combined detection of seven TAAbs and three tumor markers could be useful in early diagnosis of lung cancer.

Low expression of miR-27b in serum exosomes of non-small cell lung cancer facilitates its progression by affecting EGFR

Non-small cell lung cancer (NSCLC) is a malignant tumor. Serum exosomal miR-27b is related to tumor diagnosis. We explored the roles of serum exosomal miR-27b in NSCLC. NSCLC patients were assigned to NSCLC-early/terminal groups, with healthy subjects as controls. miR-27b expression was assessed using reverse transcription-quantitative polymerase chain reaction, and its diagnostic efficiency was analyzed using the receiver operating characteristic curve. The correlation between serum exosomal miR-27b expression and tumor markers carcinoembryonic antigen 125 (CA125), carcinoembryonic antigen (CEA), and cytokeratin 19-soluble fragment (CYFRA21-1) was analyzed using the Pearson analysis. The downstream target genes were predicted. Epidermal growth factor receptor (EGFR) level was assessed using enzyme-linked immunosorbent assay. Correlations of miR-27b expression with serum EGFR level and CA125, CEA, and CYFRA21-1 levels were analyzed using the Pearson analysis. Serum exosomal miR-27b was diminished in NSCLC and was further decreased in the NSCLS-terminal group. The sensitivity of miR-27b < 0.8150 for NSCLC diagnosis was 76.64%, and the specificity was 83.33%. Serum exosomal miR-27b was negatively correlated with CA125, CEA, and CYFRA21-1. miR-27b targeted EGFR. Serum EGFR was raised in NSCLC and was further elevated in the NSCLS-terminal group. miR-27b expression was negatively correlated with EGFR level. EGFR level was positively correlated with CA125, CEA, and CYFRA21-1 levels. Collectively, low expression of miR-27b assisted NSCLC diagnosis, and miR-27b exerted effects on NSCLC through EGFR.