Diagnostic Value of Combining Tumor and Inflammatory Markers in Lung Cancer

Abstract

BackgroundDespite major advances in lung cancer treatment, early detection remains the most promising way of improving outcomes. To detect lung cancer in earlier stages, many serum biomarkers have been tested. Unfortunately, no single biomarker can reliably detect lung cancer. We combined a set of 2 tumor markers and 4 inflammatory or metabolic markers and tried to validate the diagnostic performance in lung cancer.MethodsWe collected serum samples from 355 lung cancer patients and 590 control subjects and divided them into training and validation datasets. After measuring serum levels of 6 biomarkers (human epididymis secretory protein 4 [HE4], carcinoembryonic antigen [CEA], regulated on activation, normal T cell expressed and secreted [RANTES], apolipoprotein A2 [ApoA2], transthyretin [TTR], and secretory vascular cell adhesion molecule-1 [sVCAM-1]), we tested various sets of biomarkers for their diagnostic performance in lung cancer.ResultsIn a training dataset, the area under the curve (AUC) values were 0.821 for HE4, 0.753 for CEA, 0.858 for RANTES, 0.867 for ApoA2, 0.830 for TTR, and 0.552 for sVCAM-1. A model using all 6 biomarkers and age yielded an AUC value of 0.986 and sensitivity of 93.2% (cutoff at specificity 94%). Applying this model to the validation dataset showed similar results. The AUC value of the model was 0.988, with sensitivity of 93.33% and specificity of 92.00% at the same cutoff point used in the validation dataset. Analyses by stages and histologic subtypes all yielded similar results.ConclusionsCombining multiple tumor and systemic inflammatory markers proved to be a valid strategy in the diagnosis of lung cancer.

Beyond the Biomarker: Understanding the Diverse Roles of Human Epididymis Protein 4 in the Pathogenesis of Epithelial Ovarian Cancer

“…Human epididymis protein 4 has been investigated as a putative biomarker in endometrial ( 25 – 39 ), lung ( 40 – 52 ), breast ( 53 , 54 ), pancreatic ( 55 , 56 ), and gastric cancer ( 57 ). While the majority of these studies examine the value of HE4 as a clinical biomarker for detecting and monitoring disease, one study investigated the molecular mechanisms of HE4 in pancreatic and endometrial cancer.…”

Prognostic impact of serum transthyretin in patients with non‑small cell lung cancer

“…Lung cancer is the leading cause of cancer death worldwide, accounting for 19.4% of cancer deaths in adults (1). It is essentially divided into two types: Small-cell lung cancer (approximately 15%) and non-small cell lung cancer (NSCLC) (approximately 85%).…”

Serum Biomarkers May Prognosticate Recurrence in Node-Negative, Non-Small Cell Lung Cancers Less Than 4 Centimeters

“…The current panel for prognosticating recurrence in patients with patients with resected, node-negative NSCLC includes HE4, IGFBP-1, b-HCG, follistatin, prolactin, angiopoietin-2, and HGF. Human epididymis protein 4 has been previously reported to have diagnostic capabilities in early stage lung cancer [22][23][24], predict response to chemoradiotherapy [25], and have prognostic value for overall survival [26,27] and disease recurrence [28]. Notably, HE4 was strongly associated with metastatic progression of NSCLC, independent of T stage.…”