Role of a serum-based biomarker panel in the early diagnosis of lung cancer for a cohort of high-risk patients

Cancer. 2015 Sep 1;121 Suppl 17:3113-21. doi: 10.1002/cncr.29551.

Abstract

Background: This study applied a combined cancer biomarker panel to clinically identify small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) in a high-risk population.

Methods: The serum levels of 4 biomarkers (progastrin-releasing peptide [ProGRP], carcinoembryonic antigen [CEA], squamous cell carcinoma antigen [SCC], and cytokeratin 19 fragment [CYFRA21-1]) were determined in 153 patients with a high risk of lung cancer (12 with a new diagnosis of SCLC, 52 with NSCLC, and 89 without lung cancer). Information about diagnosis delays was collected through interviews of all participants.

Results: Significantly higher serum levels of ProGRP (P < .0001) were found among the SCLC patients versus the rest of the population. A receiver operating characteristic curve analysis established the cutoff values of ProGRP, CEA, SCC, and CYFRA21-1 as 300 pg/mL, 7.3 ng/mL, 3 ng/mL, and 6.5 ng/mL, respectively. The sensitivity and specificity of ProGRP in diagnosing SCLC were 75% and 100%, respectively. Among the 14 lung cancer patients with a false-negative computed tomography (CT) result, the diagnostic panel detected 8 additional cancers.

Conclusions: This panel increased the diagnostic specificity for high-risk subjects (those with renal failure being excluded), and auxiliary to a CT scan, it increased the sensitivity for patients with lung cancer. These results might be applied to shorten the diagnosis delay at health care institutions in China.

Keywords: biomarker; delayed diagnosis; non-small cell lung cancer; progastrin-releasing peptide (ProGRP); small cell lung cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antigens, Neoplasm / blood
  • Biomarkers, Tumor / blood*
  • Carcinoembryonic Antigen / blood
  • Carcinoma, Non-Small-Cell Lung / blood*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • China
  • Early Detection of Cancer*
  • Female
  • Humans
  • Keratin-19 / blood
  • Male
  • Middle Aged
  • Peptide Fragments / blood
  • Recombinant Proteins / blood
  • Serpins / blood
  • Small Cell Lung Carcinoma / blood*
  • Small Cell Lung Carcinoma / pathology

Substances

  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • Keratin-19
  • Peptide Fragments
  • Recombinant Proteins
  • Serpins
  • antigen CYFRA21.1
  • pro-gastrin-releasing peptide (31-98)
  • squamous cell carcinoma-related antigen