CA-125, CA-153, and CYFRA21-1 as clinical indicators in male lung cancer with ocular metastasis

Update value and clinical application of MUC16 (cancer antigen 125)

INTRODUCTION

The largest transmembrane mucin, mucin 16 (MUC16), contains abundant glycosylation sites on the molecular surface, allowing it to participate in various molecular pathways. When cells lose polarity and become cancerous, MUC16 is overexpressed, and more of the extracellular region (cancer antigen [CA]125) is released into serum and possibly, promote the development of diseases. Thus, MUC16 plays an indispensable role in clinical research and application.

AREAS COVERED

This review summarizes the update proposed role of MUC16 in carcinogenesis and metastasis. Most importantly, we prospect its potential value in targeted therapy after screening 1226 articles published within the last 10 years from PubMed. Two reviewers screened each record and each report retrieved independently. We have summarized the progress of MUC16/CA125 in basic research and clinical application, and predicted its possible future development directions.

EXPERT OPINION

As an important noninvasive co-factor in the diagnosis of gynecological diseases, MUC16 has been used for a long time, especially in the diagnosis and treatment of ovarian cancer. The overexpression of MUC16 plays a very obvious role in regulating inflammatory response, supporting immune suppression, and promoting the proliferation, division, and metastasis of cancer cells. In the next 20 years, there will be a luxuriant clinical application of MUC16 as a target for immune monitoring and immunotherapy.

Diagnostic and prognostic value of serum CircERBB2 level in NSCLC and its correlation with clinicopathological features in NSCLC patients

OBJECTIVE

To explore the relationship between serum circular RNA ERBB2 (CircERBB2) levels and clinicopathological features and prognosis of patients with non-small cell lung cancer (NSCLC).

METHODS

In this retrospective study, 87 patients with NSCLC (NSCLC group) and 85 patients with benign lung disease (benign lung disease group) in the First Affiliated Hospital of Yangtze University from March 2016 to February 2019 were enrolled; in addition, another 87 healthy subjects were selected as the control group. Serum levels of CircERBB2, cytokeratin 19 fragment (CYFRA21-1) and carcinoembryonic antigen (CEA) in each group were detected, and their relationship with the prognosis of NSCLC patients as well as their diagnostic value was analyzed. The serum CircERBB2 levels in NSCLC patients with different clinicopathological characteristics were compared, and the correlation of serum level of CircERBB2 with CircERBB2 as well as CYFRA21-1 was analyzed.

RESULTS

The serum CircERBB2, CYFRA21-1 and CEA levels in the control group, benign lung disease group and NSCLC group were gradually increased (P<0.05). In the NSCLC group, serum CircERBB2 level was correlated with lymph node metastasis, tumor diameter and TNM stage (P<0.05). The areas under the curve (AUCs) of serum CircERBB2, CYFRA21-1, and CEA in diagnosing NSCLC were 0.871, 0.693, and 0.861, with cut-off values of 2.27, 4.45 ng/mL, and 18.49 ng/mL, respectively. The sensitivity was 80.5%, 65.5%, 78.2%, the specificity was 87.1%, 74.1%, 88.2%, respectively. The AUC and sensitivity of CircERBB2 combined with CEA in diagnosing NSCLC was 0.938 and 94.3%, respectively. The serum CircERBB2 level was positively correlated with CYFRA21-1 and CEA in the NSCLC group (P<0.05); and the levels of the above three serum indexes were significantly higher in the death group than those in the survival group (all P<0.05). The 36-month cumulative survival rate of patients in the CircERBB2 low expression group was longer than that in the CircERBB2 high expression group (P<0.05).

CONCLUSION

Serum CircERBB2 is highly expressed in NSCLC patients, and closely related to disease progression, so it has good prognostic value.

CoNi-RGO and NiCo2S4-ZIF/g-C3N4 signal amplified electrochemical immunosensors for sensitive detection of CYFRA 21-1

Herein, a signal amplified electrochemical immunosensor for the sensitive detection of cytokeratin 19 fragments (CYFRA 21-1) in human serum was discussed. The CoNi-RGO was used as a substrate for the sensor with excellent specific surface area and strong electrical conductivity, which enables more efficient attachment of antibodies. The introduction of the bimetallic sulfide NiCo₂S₄ composite ZIF material provides strong catalytic performance for the immunosensor. It is worth noting that, in addition to these satisfactory advantages, these two materials also show amazing signal amplification capacity. When the immunosensor works, the increase in electrical impedance decreases the electron transfer rate, making the electrochemical signal change obvious. The signal enhancement of immunosensors was emphasized by the marker during construction, and the experimental results were satisfactory. The proposed signal enhanced immunosensor had a linear relationship in the range of 0.001-10 ng/mL for CYFRA 21-1, and the minimum detection limit was 0.33 pg/mL for △I = 95.22 + 23.27 lg c. This demonstrates that the electrochemical immunosensor we constructed is successful and has a great developing potential.

Camrelizumab and Apatinib Combined with Radiotherapy Is Effective in Advanced Oligometastatic Non-Small-Cell Lung Cancer

Objective. To investigate the effect of camrelizumab + apatinib combined with radiotherapy on the expression of TRIM27, SCC-Ag, and CYFRA21-1 in advanced oligometastatic non-small-cell lung cancer (NSCLC). Methods. A retrospective analysis of patients with oligometastatic NSCLC who were treated at our hospital from January 1, 2021, to March 31, 2022. Patients who met the inclusion criteria were summarized into an observation group (camrelizumab on the basis of the control group), or a control group (radiotherapy combined with oral apatinib). The disease control rate, immune function, changes in the levels of TRIM27, SCC-Ag, CYFRA21-1, and the occurrence of adverse effects were compared between the two groups. Result. There were 86 patients who met the inclusion criteria, with 53 cases in the observation group and 33 cases in the control group. There were significant differences in complete remission (CR, 25/53 vs. 10/33), partial remission (PR, 17/53 vs. 12/33), disease control (DC, 7/53 vs. 4/33), disease progression (DP, 4/53 vs. 7/33), and disease control rate (49/53 vs. 26/33) between the observation group and the control group. There was no significant difference in immune function between the two groups before treatment ( $p>0.05$ ). After treatment, the levels of CD3+, CD4+, CD4+/CD8+t cells, and NK cells in the observation group were higher ( $p=0.015$ , 0.035, 0.003, 0.001, respectively), while the level of CD8+t cells was lower ( $p<0.001$ ). There were no significant differences in TRIM27, SCC-Ag, or CYFRA21-1 between the two groups before treatment ( $p>0.05$ ). After treatment, the observation group had lower levels of TRIM27 ( $p=0.035$ ), SCC-Ag ( $p=0.045$ ), and CYFRA21-1 ( $p=0.003$ ). There was no significant difference in the occurrence of adverse events between the two groups ( $p<0.05$ ). Conclusion. Treatment of camrelizumab + apatinib combined with radiotherapy is effective for advanced oligometastatic NSCLC, with mild adverse effects.

Development and Validation of a Novel Nomogram for Predicting Tumor-Distant-Metastasis in Patients with Early T1-2 Stage Lung Adenocarcinoma

Background

Distant metastasis in early T1-2 (diameter≤5 cm) stage lung adenocarcinoma (ET-LUAD) patients largely affect treatment strategies in clinical practice. However, the associated mechanism remains unclear and related studies is less. This study aimed to establish and validate a novel nomogram to predict the risk of distant metastasis in ET-LUAD.

Methods

A total of 258 patients diagnosed with ET-LUAD and not receiving any treatment were recruited into this study. The patients were randomly divided into a training cohort and validation cohort in a ratio of 1:2. Univariate and multivariate logistic regression analysis was used to select the most significant predictive risk factors associated with distant metastasis in the training cohort. The established nomogram was validated by the consistency index (C-index), calibration curve, and decision curve analysis (DCA).

Results

There were 124 patients with confirmed distant metastasis and 134 patients with non-distant metastases ET-LUAD were enrolled in the study. Multivariate logistic hazards regression analysis identified independent risk factors associated with distant metastasis to include platelet-to-lymphocyte ratios (PLR), lactate dehydrogenase (LDH), neural-specific enolase (NSE), carcinoembryonic antigen (CEA) and cytokeratin 19 fragments (Cyfra211), which were included in the establishment of the nomogram. The nomogram achieved a high consistency (C-index=0.792), good calibration, and high clinical application value in the validation cohort.

Conclusion

The established nomogram can be used to predict distant metastasis in high-risk ET-LUAD nonmetastasis patients and can also be used by doctors to guide preventive and individualized treatment for ET-LUAD patients.

Prognostic significance of pre-treatment serum Cyfra21-1 as a tumor marker in patients with oropharyngeal squamous cell carcinoma treated with concurrent chemoradiotherapy

Background

Oropharyngeal squamous cell carcinoma (OPSCC) is a kind of squamous cell carcinoma of head and neck, and its incidence is on the rise in recent years. A variety of prognostic markers for OPSCC have been reported in many studies, but they are expensive or difficult to obtain. So, we retrospectively studied the prognostic significance of cytokeratin 19 soluble fragment (Cyfra21-1) in patients with OPSCC, in order to provide theoretical basis for accurate prognosis assessment.

Methods

A retrospective analysis of the clinicopathological data of 85 OPSCC patients with concurrent radiotherapy and chemotherapy (CRT) admitted from January 2010 to June 2017. Serum Cyfra21-1 levels were measured before treatment. Analyze the relationship between Cyfra21-1 and clinical pathological characteristics of patients. The receiver operating characteristic (ROC) curve was used to calculate the cut-off value of Cyfra21-1. The Cox proportional hazard model was used to conduct univariate and multivariate analysis of related prognostic factors, and to determine the factors related to overall survival (OS) and progression-free survival (PFS).

Results

The cutoff value for Cyfra21-1 was 2.93 ng/mL. The baseline data of patients in different Cyfra21-1 groups were balanced and comparable. In the univariate and multivariate analyses, it was found that Cyfra21-1 was associated with OS and PFS. A measurement of Cyfra21-1 ≥2.93 ng/mL indicated poor OS (P<0.001) and PFS (P=0.001). After adjusting for age and disease stage, Cyfra21-1 can independently affect the OS (HR =3.57, 95% CI: 1.60-7.99, P=0.002) and PFS (HR =2.89, 95% CI: 1.41-5.91, P=0.004) of patients with OPSCC treated with CRT.

Conclusions

Pre-treatment Cyfra21-1 can be used as a prognostic marker for patients with OPSCC treated with CRT, which has important clinical significance.