Urinary Protein Biomarkers in the Early Detection of Lung Cancer

Abstract

The early detection of lung cancer has the potential to greatly impact disease burden through the timely identification and treatment of affected individuals at a manageable stage of development. The insufficient specificity demonstrated by currently used screening and diagnostic techniques has led to intense investigation into biomarkers as diagnostic tools. Urine may represent a non-invasive alternative matrix for diagnostic biomarker development. We performed an analysis of 242 biomarkers in urines obtained from 83 NSCLC patients, 74 patients diagnosed with benign pulmonary conditions and 77 healthy donors. A large number of significant alterations were observed between the NSCLC and control groups. A multivariate analysis identified a three biomarker panel consisting of IGFBP-1, sIL-1Ra, CEACAM-1 which discriminated NSCLC from healthy controls with a SN/SP of 84/95 in an initial training set and 72/100 in an independent validation set. This panel performed well among multiple subtypes of NSCLC and early stage disease but demonstrated only limited efficacy for the discrimination of NSCLC from benign controls and limited specificity for several other cancers and tuberculosis patients. These findings demonstrate that urine biomarkers may provide screening and diagnostic properties which exceed those reported for serum biomarkers and approach a level necessary for further clinical development.

Volatile organic compounds of biofluids for detecting lung cancer by an electronic nose based on artificial neural network

“…While early detection of small cancerous lesions carries the benefit of wider treatment options and better prognosis of LC patients, the process of obtaining a tissue biopsy to confirm a cancerous tissue is not free of complications and bears incon- veniences and stress to the patient. Despite advances in technology and intensive research efforts, no molecular biomarker capable of identifying LC in the early stages has been found to be suitable for clinical use (Nolen et al, 2015;Zhang et al, 2015). Research efforts have been focused on identifying sensitive and specific blood-based biomarkers for early detection of LC, such as: identification of proteins, protein panels or antibodies to tumor-associated antigens; analysis of epigenetic changes such as methylation; microRNA profiling; and gene expression profiling (Tsay et al, 2013).…”

A Prediction Model Based on Biomarkers and Clinical Characteristics for Detection of Lung Cancer in Pulmonary Nodules

“…1) Based on the Food and Drug Administration criteria [24], any screening test directed at a disease with a prevalence of 5% or less must detect preclinical disease with a sensitivity exceeding 95% when the specificity is less than or equal to 95%, and vice versa [24]. The prevalence of lung cancer in high-risk groups is at 1% to 3%, whereas LDCT has about 90% sensitivity and 61% specificity for lung cancer early detection.…”

Emerging non‑invasive detection methodologies for lung cancer (Review)

“…Protein profiling is another diagnostic method based on liquid biopsy (39). Numerous studies on LC protein biomarkers have been conducted in blood, urine, saliva and exhaled breath condensate (EBC) samples (40)(41)(42). Common protein biomarkers for LC, including CEA and cytokeratin fragment 21-1, are not sensitive enough to detect early tumors (43).…”