Role of a serum-based biomarker panel in the early diagnosis of lung cancer for a cohort of high-risk patients.
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.
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Respiratory Research Institute, Shanghai, China.
Da-Wei
DW
Yang
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Respiratory Research Institute, Shanghai, China.
Yong
Y
Zhang
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Respiratory Research Institute, Shanghai, China.
Qun-Ying
QY
Hong
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Respiratory Research Institute, Shanghai, China.
Jie
J
Hu
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Respiratory Research Institute, Shanghai, China.
Chun
C
Li
Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Bai-Shen
BS
Pan
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Qun
Q
Wang
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Fei-Hong
FH
Ding
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Jia-Xian
JX
Ou
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Fang-Lei
FL
Liu
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Dan
D
Zhang
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Jie-Bai
JB
Zhou
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Respiratory Research Institute, Shanghai, China.
Yuan-Lin
YL
Song
Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.|Shanghai Respiratory Research Institute, Shanghai, China.|State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, China.
Chun-Xue
CX
Bai
D000368:Aged; 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; D002681:China; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000097:blood; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011994:Recombinant Proteins / Q000097:blood; D015843:Serpins / Q000097:blood; D055752:Small Cell Lung Carcinoma / Q000097:blood* / Q000473:pathology
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D010446:Peptide Fragments; D011994:Recombinant Proteins; D015843:Serpins; C102012:antigen CYFRA21.1; C087079:pro-gastrin-releasing peptide (31-98); C051072:squamous cell carcinoma-related antigen
biomarker; delayed diagnosis; non-small cell lung cancer; progastrin-releasing peptide (ProGRP); small cell lung cancer