The diagnostic and prognostic value of ProGRP in lung cancer.
OBJECTIVE
To investigate the diagnostic and prognostic significance of pro-gastrin-releasing peptide (ProGRP) in non-small cell (NSCLC) and small cell lung cancer (SCLC) and compare this marker with other known serum markers in lung cancer.


METHODS
Serum levels of ProGRP, neuron-specific enolase (NSE), CYFRA 21-1 and carcinoembryonic antigen (CEA) were measured in 37 patients with benign pulmonary disease (BPD), 88 with advanced NSCLC and 37 with SCLC.


RESULTS
The ProGRP assay showed a better clinical performance than that of NSE in discriminating between SCLC and BPD or NSCLC, especially at specificity higher than 90%. ProGRP and NSE sensitivity in SCLC at 95% specificity versus the BPD group was 78.4% and 48.6%, (p=0.001) and at 97.7% specificity versus NSCLC, 75.7% and 37.8%, respectively (p=0.001). A significant association of low ProGRP levels with high-grade NSCLC tumors was found (p=0.002). A univariate analysis showed a significant association of ProGRP with survival both in NSCLC and SCLC (p=0.03 and p=0.04, respectively). In multivariate analysis, performance status (PS) and CYFRA 21-1 in NSCLC, and PS, CYFRA 21-1 and serum lactic dehydrogenase in SCLC were found as significant variables with an independent impact on survival.


CONCLUSIONS
ProGRP is a useful marker in SCLC, with diagnostic performance better than that of NSE and demonstrating association with survival in NSCLC and SCLC limited to univariate analysis.
Nisman
Benjamin
B
Department of Oncology, Hadassah and Hebrew University Medical Centre, Jerusalem 91120, Israel. nisman@hadassah.org.il
Biran
Haim
H
Ramu
Nili
N
Heching
Norman
N
Barak
Vivian
V
Peretz
Tamar
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000473:pathology; D018288:Carcinoma, Small Cell / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000097:blood; D008175:Lung Neoplasms / Q000097:blood* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010446:Peptide Fragments / Q000097:blood*; D010751:Phosphopyruvate Hydratase / Q000097:blood; D011446:Prospective Studies; D012372:ROC Curve; D011994:Recombinant Proteins / Q000097:blood; D015996:Survival Rate
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D010446:Peptide Fragments; D011994:Recombinant Proteins; C102012:antigen CYFRA21.1; C087079:pro-gastrin-releasing peptide (31-98); D010751:Phosphopyruvate Hydratase