title: Reactive oxygen species modulator 1 (Romo1) as a novel diagnostic marker for lung cancer-related malignant effusion.
abstract: Reactive oxygen species modulator 1 (Romo1) is a novel protein that plays an important role in intracellular reactive oxygen species generation. Recently, Romo1 has been suggested to have diagnostic and prognostic potential in lung cancer. However, there is no data on the diagnostic value of Romo1 level in malignant pleural effusion. We evaluated the clinical usefulness of Romo1 in pleural fluid for the diagnosis of malignant effusion in lung cancer patients. Pleural fluid Romo1 level was measured using enzyme-linked immunosorbent assay and compared between lung cancer-associated malignant effusion (n = 53; 29 adenocarcinomas and 24 squamous cell carcinomas) and benign pleural effusions (n = 91; 31 tuberculous pleurisy, 30 parapneumonic effusion, and 30 transudate). The discriminative power of Romo1 for lung cancer-associated malignant effusion was determined using receiver operating characteristic (ROC) curve analysis and compared with those of other tumor markers. Median Romo1 level in lung cancer-associated malignant effusion was 99.3 ng/mL, which was significantly higher than that in benign pleural effusions (P < 0.001). The optimal cutoff value of Romo1 to discriminate lung cancer-associated malignant effusion from benign effusions was 67.0 ng/mL with a sensitivity of 73.8% and a specificity of 84.1%. The area under the curve was 0.837 (95% confidence interval [CI]: 0.750-0.886), which was significantly better than that of cytokeratin 19 fragments (P < 0.001). Pleural fluid Romo1 could discriminate lung cancer from benign diseases with considerable sensitivity and specificity. Our findings suggest a diagnostic potential of Romo1 for lung cancer-associated malignant effusion.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University School of Medicine Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea.
authors.forename: Seung Hyeun
authors.initials: SH
authors.lastname: Lee
authors.forename: Myung Jae
authors.initials: MJ
authors.lastname: Park
authors.forename: Sue In
authors.initials: SI
authors.lastname: Choi
authors.forename: Eun Joo
authors.initials: EJ
authors.lastname: Lee
authors.forename: Sang Yeub
authors.initials: SY
authors.lastname: Lee
authors.forename: Kwang Ho
authors.initials: KH
authors.lastname: In
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000032:analysis; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008565:Membrane Proteins / Q000032:analysis*; D008875:Middle Aged; D024101:Mitochondrial Proteins / Q000032:analysis*; D016066:Pleural Effusion, Malignant / Q000737:chemistry*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D000951:Antigens, Neoplasm; D015415:Biomarkers; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D008565:Membrane Proteins; D024101:Mitochondrial Proteins; C513338:ROMO1 protein, human; C102012:antigen CYFRA21.1