Prognostic and diagnostic potential of local and circulating levels of pentraxin 3 in lung cancer patients.
There is a well-established link between inflammation and cancer of various organs, but little data are available on inflammation-associated markers of diagnostic and prognostic clinical utility in pulmonary malignancy. Blood samples were prospectively collected from 75 resectable lung cancer patients before surgery and in a cohort of 1,358 high-risk subjects. Serum levels of long pentraxin 3 (PTX3) were determined by high-sensitivity ELISA. PTX3 immunostaining was evaluated by immunohistochemistry in cancer tissue. Serum PTX3 levels in the high-risk population were not predictive of developing subsequent lung cancer or any other malignancy; however, serum PTX3 values in patients with lung cancer were significantly higher compared with cancer-free heavy smokers. With a cutoff of 4.5 ng/ml, specificity was 0.80, sensitivity 0.69, positive predictive value 0.15 and negative predictive value 0.98. The receiver operating curve (ROC) for serum PTX3 had an area under the curve (AUC) of 83.52%. Preoperative serum PTX3 levels in lung cancer patients did not correlate with patient outcome, but high interstitial expression of PTX3 in resected tumor specimens was a significant independent prognostic factor associated with shorter survival (p < 0.001). These results support the potential of serum PTX3 as a lung cancer biomarker in high-risk subjects. Furthermore, PTX3 immunohistochemistry findings support the role of local inflammatory mechanisms in determining clinical outcome and suggest that local expression of PTX3 may be of prognostic utility in lung cancer patients.
Thoracic Surgery Department, Humanitas Research Hospital, Rozzano, Milano, Italy.
Maurizio
M
Infante
Humanitas Research Center, Rozzano, Milano, Italy.
Paola
P
Allavena
Humanitas Research Center, Rozzano, Milano, Italy.
Cecilia
C
Garlanda
Department of Pathology, University of Milan, L. Sacco Hospital, Milano, Italy.
Manuela
M
Nebuloni
Biostatistical Unit, Humanitas Research Hospital, Rozzano, Milano, Italy.
Emanuela
E
Morenghi
Department of Pathology, Humanitas Research Hospital, Rozzano, Milano, Italy.
Daoud
D
Rahal
Department of Pathology, Humanitas Research Hospital, Rozzano, Milano, Italy.
Massimo
M
Roncalli
Department of Infrastructure Research and Statistics, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
Silvio
S
Cavuto
Humanitas Research Center, Rozzano, Milano, Italy.
Samantha
S
Pesce
Humanitas Research Center, Rozzano, Milano, Italy.
Marta
M
Monari
Clinical Investigation Laboratory, Fondazione IRCCS Policlinico San Matteo Hospital, Pavia, Italy.
Serenella
S
Valaperta
Humanitas Research Center, Rozzano, Milano, Italy.
Alessandro
A
Montanelli
Department of General Surgery, Rabin Medical Center, Petah Tiqva, Israel.
Daniel
D
Solomon
Thoracic Surgery Department, Humanitas Research Hospital, Rozzano, Milano, Italy.
Edoardo
E
Bottoni
Thoracic Surgery Department, Humanitas Research Hospital, Rozzano, Milano, Italy.
Valentina
V
Errico
Thoracic Surgery Department, Humanitas Research Hospital, Rozzano, Milano, Italy.
Emanuele
E
Voulaz
Service de Chirurgie Digestive et Metabolique, Hôpital Jean Verdier, Bondy, France.
Manuela
M
Bossi
Thoracic Surgery Department, Humanitas-Gavazzeni Hospital, Bergamo, Italy.
Giuseppe
G
Chiesa
Thoracic Surgery Department, Humanitas-Gavazzeni Hospital, Bergamo, Italy.
Eliseo
E
Passera
Humanitas Research Center, Rozzano, Milano, Italy.|Humanitas University, Rozzano, Milano, Italy.
Alberto
A
Mantovani
Thoracic Surgery Department, Humanitas Research Hospital, Rozzano, Milano, Italy.
Marco
M
Alloisio
D000368:Aged; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis / Q000096:biosynthesis*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012680:Sensitivity and Specificity; D000683:Serum Amyloid P-Component / Q000032:analysis / Q000096:biosynthesis*; D000099153:Pentraxins
D014408:Biomarkers, Tumor; D002097:C-Reactive Protein; D000683:Serum Amyloid P-Component; D000099153:Pentraxins
NSCLC; PTX3; biomarker; inflammation