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Kong C, Lai L, Jin X, Chen W, Ding J, Zheng L, Zhang D, Ying X, Chen X, Chen M, Tu J, Ji J. Machine Learning Classifier for Preoperative Prediction of Early Recurrence After Bronchial Arterial Chemoembolization Treatment in Lung Cancer Patients. Acad Radiol 2023; 30:2880-2893. [PMID: 37225529 DOI: 10.1016/j.acra.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 05/26/2023]
Abstract
RATIONALE AND OBJECTIVES Bronchial arterial chemoembolization (BACE) was deemed as an effective and safe approach for advanced standard treatment-ineligible/rejected lung cancer patients. However, the therapeutic outcome of BACE varies greatly and there is no reliable prognostic tool in clinical practice. This study aimed to investigate the effectiveness of radiomics features in predicting tumor recurrence after BACE treatment in lung cancer patients. MATERIALS AND METHODS A total of 116 patients with pathologically confirmed lung cancer who received BACE treatment were retrospectively recruited. All patients underwent contrast-enhanced CT within 2 weeks before BACE treatment and were followed up for more than 6 months. We conducted a machine learning-based characterization of each lesion on the preoperative contrast-enhanced CT images. In the training cohort, recurrence-related radiomics features were screened by least absolute shrinkage and selection operator (LASSO) regression. Three predictive radiomics signatures were built with linear discriminant analysis (LDA), support vector machine (SVM) and logistic regression (LR) algorithms, respectively. Univariate and multivariate LR analyses were performed to select the independent clinical predictors for recurrence. The radiomics signature with best predictive performance was integrated with the clinical predictors to form a combined model, which was visualized as a nomogram. The performance of the combined model was assessed by receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA). RESULTS Nine recurrence-related radiomics features were screened out, and three radiomics signatures (RadscoreLDA, RadscoreSVM and RadscoreLR) were built based on these features. Patients were classified into the low-risk and high-risk groups based on the optimal threshold of three signatures. Progression-free survival (PFS) analysis showed that patients of low-risk group achieved longer PFS than patients of high-risk group (P < 0.05). The combined model including RadscoreLDA and independent clinical predictors (tumor size, carcinoembryonic antigen and pro-gastrin releasing peptide) achieved the best predictive performance for recurrence after BACE treatment. It yields AUCs of 0.865 and 0.867 in the training and validation cohorts, with accuracy (ACC) of 0.804 and 0.750, respectively. Calibration curves indicated that the probability of recurrence predicted by the model fits well with the actual recurrence probability. DCA showed that the radiomics nomogram was clinically useful. CONCLUSION The radiomics and clinical predictors-based nomogram can predict tumor recurrence after BACE treatment effectively, which allowing oncologists to identify potential recurrence and enable better patient management and clinical decision-making.
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Affiliation(s)
- Chunli Kong
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China (C.K., L.L., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Department of Radiology, Lishui Hospital of Zhejiang University, Lishui 323000, China (C.K., L.L., W.C., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.)
| | - Linqiang Lai
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China (C.K., L.L., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Department of Radiology, Lishui Hospital of Zhejiang University, Lishui 323000, China (C.K., L.L., W.C., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.)
| | - Xiaofeng Jin
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.)
| | - Weiyue Chen
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China (C.K., L.L., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Department of Radiology, Lishui Hospital of Zhejiang University, Lishui 323000, China (C.K., L.L., W.C., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.)
| | - Jiayi Ding
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China (C.K., L.L., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.)
| | - Liyun Zheng
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China (C.K., L.L., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Department of Radiology, Lishui Hospital of Zhejiang University, Lishui 323000, China (C.K., L.L., W.C., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.)
| | - Dengke Zhang
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China (C.K., L.L., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Department of Radiology, Lishui Hospital of Zhejiang University, Lishui 323000, China (C.K., L.L., W.C., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.)
| | - Xihui Ying
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China (C.K., L.L., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Department of Radiology, Lishui Hospital of Zhejiang University, Lishui 323000, China (C.K., L.L., W.C., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.)
| | - Xiaoxiao Chen
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China (C.K., L.L., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Department of Radiology, Lishui Hospital of Zhejiang University, Lishui 323000, China (C.K., L.L., W.C., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.)
| | - Minjiang Chen
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China (C.K., L.L., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Department of Radiology, Lishui Hospital of Zhejiang University, Lishui 323000, China (C.K., L.L., W.C., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.)
| | - Jianfei Tu
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China (C.K., L.L., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Department of Radiology, Lishui Hospital of Zhejiang University, Lishui 323000, China (C.K., L.L., W.C., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.)
| | - Jiansong Ji
- Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, Institute of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui 323000, China (C.K., L.L., X.J., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China (C.K., L.L., W.C., J.D., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.); Department of Radiology, Lishui Hospital of Zhejiang University, Lishui 323000, China (C.K., L.L., W.C., L.Z., D.Z., X.Y., X.C., M.C., J.T., J.J.).
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Li T, Xie Q, Fang YY, Sun Y, Wang XM, Luo Z, Yan GL, He JB, Zheng XQ. Prognostic value of CYFRA 21 - 1 and Ki67 in advanced NSCLC patients with wild-type EGFR. BMC Cancer 2023; 23:295. [PMID: 37004004 PMCID: PMC10064697 DOI: 10.1186/s12885-023-10767-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND The prognostic value of cytokeratin 19 fragment (CYFRA 21 - 1) and Ki67 in advanced non-small cell lung cancer (NSCLC) patients with wild-type epidermal growth factor receptor (EGFR) remains to be explored. METHODS In this study, 983 primary NSCLC patients from January 2016 to December 2019 were retrospectively reviewed. Finally, 117 advanced NSCLC patients with wild-type EGFR and 37 patients with EGFR mutation were included and prognostic value of CYFRA 21 - 1 and Ki67 were also identified. RESULTS The patients age, smoking history and the Eastern Corporative Oncology Group (ECOG) performance scores were significantly different between CYFRA21-1 positive and negative groups (p < 0.05), while no significant differences were found in Ki67 high and low groups. The results of over survival (OS) demonstrated that patients with CYFRA21-1 positive had markedly shorter survival time than CYFRA21-1 negative (p < 0.001, For whole cohorts; p = 0.002, For wild-type EGFR). Besides, patients with wild-type EGFR also had shorter survival times than Ki67 high group. Moreover, In CYFRA 21 - 1 positive group, patients with Ki67 high had obviously shorter survival time compared to patients with Ki67 low (median: 24vs23.5 months; p = 0.048). However, Ki67 could not be used as an adverse risk factor for patients with EGFR mutation. Multivariate cox analysis showed that age (HR, 1.031; 95%CI, 1.003 ~ 1.006; p = 0.028), Histopathology (HR, 1.760; 95%CI,1.152 ~ 2.690; p = 0.009), CYFRA 21 - 1 (HR, 2.304; 95%CI,1.224 ~ 4.335; p = 0.01) and Ki67 (HR, 2.130; 95%CI,1.242 ~ 3.652; p = 0.006) served as independent prognostic risk factor for advanced NSCLC patients. CONCLUSIONS Our finding indicated that CYFRA 21 - 1 was an independent prognostic factor for advanced NSCLC patients and Ki67 status could be a risk stratification marker for CYFRA 21 - 1 positive NSCLC patients with wild-type EGFR.
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Affiliation(s)
- Tao Li
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Qi Xie
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Yang-Yang Fang
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Yi Sun
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Xiao Ming Wang
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Zhu Luo
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Gui-Ling Yan
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China
| | - Jian-Bo He
- Department of Respiratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Xiao-Qun Zheng
- Department of Laboratory Medicine, The Second Affiliated and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
- School of Laboratory Medicine and Life Sciences, The Key Laboratory of Laboratory Medicine, Wenzhou Medical University, Ministry of Education of China, Wenzhou, China.
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Multifunctional neuron-specific enolase: its role in lung diseases. Biosci Rep 2020; 39:220911. [PMID: 31642468 PMCID: PMC6859115 DOI: 10.1042/bsr20192732] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 12/13/2022] Open
Abstract
Neuron-specific enolase (NSE), also known as gamma (γ) enolase or enolase-2 (Eno2), is a form of glycolytic enolase isozyme and is considered a multifunctional protein. NSE is mainly expressed in the cytoplasm of neurons and neuroendocrine cells, especially in those of the amine precursor uptake and decarboxylation (APUD) lineage such as pituitary, thyroid, pancreas, intestine and lung. In addition to its well-established glycolysis function in the cytoplasm, changes in cell localization and differential expression of NSE are also associated with several pathologies such as infection, inflammation, autoimmune diseases and cancer. This article mainly discusses the role and diagnostic potential of NSE in some lung diseases.
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Muley T, Zhang X, Holdenrieder S, Korse CM, Zhi XY, Molina R, Liu Z, Hartmann G, van den Heuvel MM, Qian K, Marrades R, Engel C, He Y, Wehnl B, Dayyani F, Herth F. A continuous responder algorithm to optimize clinical management of small-cell lung cancer with progastrin-releasing peptide as a simple blood test. Tumour Biol 2020; 42:1010428320958603. [PMID: 32964798 DOI: 10.1177/1010428320958603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
This study aimed to investigate whether changes in progastrin-releasing peptide (ProGRP) levels correlate with treatment response and can be used to optimize clinical management of patients with small-cell lung cancer. Patients with small-cell lung cancer (any stage) receiving chemotherapy were eligible. ProGRP was measured in serum/plasma at baseline and after each chemotherapy cycle using the Elecsys® ProGRP assay (Roche Diagnostics). Treatment response was assessed by computed tomography scan. The primary objective was to examine whether changes in ProGRP levels correlated with computed tomography scan results after two cycles of chemotherapy. The prognostic value of ProGRP among patients receiving first-line chemotherapy was also assessed. Overall, 261 patients from six centers were eligible. Among patients with elevated baseline ProGRP (>100 pg/mL), a ProGRP decline after Cycle 2 was associated with nonprogression (area under the curve: 84%; 95% confidence interval: 72.8-95.1; n = 141). ProGRP changes from baseline to end of Cycle 1 were predictive of response, as determined by computed tomography scan 3 weeks later (area under the curve: 87%; 95% confidence interval: 74.1-99.2; n = 137). This was enhanced by repeat measurements, with a 92% area under the curve (95% confidence interval: 85.3-97.8) among patients with ProGRP data after both Cycles 1 and 2 (n = 123); if a patient experienced a ≥25% decline in ProGRP after Cycle 1, and ProGRP remained stable or decreased after Cycle 2, the probability of finding progression on the interim computed tomography scan at the end of Cycle 2 was almost zero (sensitivity: 100%, specificity: 71%). Both ProGRP levels at baseline and at the end of first-line chemotherapy were prognostic; the latter provided a moderately improved hazard ratio of 2.43 (95% confidence interval: 1.33-4.46; n = 110) versus 1.87 (95% confidence interval: 1.04-3.37; n = 216). In summary, for patients with small-cell lung cancer and elevated baseline ProGRP levels, ProGRP may be a simple, reliable, and repeatable tool for monitoring response to chemotherapy and provide valuable prognostic information.
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Affiliation(s)
- Thomas Muley
- Thoraxklinik at University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC) Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany
| | - Xiaotong Zhang
- Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | | | | | - Xiu-Yi Zhi
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Rafael Molina
- Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Zhongjuan Liu
- Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | | | - Michel M van den Heuvel
- The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kun Qian
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ramon Marrades
- Hospital Clinic, University of Barcelona, Barcelona, Spain
| | | | - Ying He
- Roche Diagnostics GmbH, Penzberg, Germany
| | | | - Farshid Dayyani
- Roche Diagnostics International, Rotkreuz, Switzerland.,University of California, Irvine, Irvine, CA, USA
| | - Felix Herth
- Thoraxklinik at University Hospital of Heidelberg, Heidelberg, Germany.,Translational Lung Research Center (TLRC) Heidelberg, German Center for Lung Research (DZL), Heidelberg, Germany
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Yoshimura A, Uchino J, Hasegawa K, Tsuji T, Shiotsu S, Yuba T, Takumi C, Yamada T, Takayama K, Hiraoka N. Carcinoembryonic antigen and CYFRA 21-1 responses as prognostic factors in advanced non-small cell lung cancer. Transl Lung Cancer Res 2019; 8:227-234. [PMID: 31367536 DOI: 10.21037/tlcr.2019.06.08] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background It is unclear whether changes in serum tumor marker expression post-treatment are of prognostic value. We investigated the associations between changes in serum carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA 21-1) after first-line treatment and overall survival (OS) in non-small cell lung cancer (NSCLC). Methods Advanced NSCLC patients (April 2010 to December 2015) with elevated serum CEA or CYFRA 21-1 were included. The associations between tumor marker changes after treatment initiation and OS were analyzed. Results Ninety-six and 55 patients were CEA- and CYFRA 21-1-positive, respectively. The serum CEA response at 4 months and CYFRA 21-1 responses at 1 and 4 months were significantly associated with OS in the univariate analyses (P=0.025, P=0.016 and P<0.001, respectively). Moreover, in the multivariate analyses, serum CYFRA 21-1 response at 4 months was significantly associated with improved OS (P=0.038). Conclusions In NSCLC patients, serum CEA and CYFRA 21-1 responses after treatment initiation may predict longer OS.
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Affiliation(s)
- Akihiro Yoshimura
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Hasegawa
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Taisuke Tsuji
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Shinsuke Shiotsu
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Tatsuya Yuba
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Chieko Takumi
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Noriya Hiraoka
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
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Mauro C, Passerini R, Spaggiari L, Galetta D, Radice D, Lentati P, Sandri MT. New and old biomarkers in the differential diagnosis of lung cancer: Pro-gastrin-releasing peptide in comparison with neuron-specific enolase, carcinoembryonic antigen, and CYFRA 21-1. Int J Biol Markers 2019; 34:163-167. [PMID: 30994045 DOI: 10.1177/1724600819834235] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Testing for circulating biomarkers in lung cancer is hampered by the insufficient specificity. We aimed to assess the relative diagnostic accuracy of pro-gastrin-releasing peptide (ProGRP) for the differential diagnosis of small cell lung cancer and compare it with more conventional biomarkers. METHODS We enrolled a cohort of 390 patients with a clinical suspicion of lung cancer and for whom a histologic assessment was available. Serum or plasma samples were assessed for ProGRP, carcinoembryonic antigen, CYFRA 21-2, and neuron-specific enolase. The performance of each biomarker in discriminating the small cell lung cancer and squamous cell carcinoma/adenocarcinoma from non-malignant lung disease, and small cell lung cancer from squamous cell carcinoma/adenocarcinoma, was assayed by receiver operating characteristic curve analysis. RESULTS At the cut-off levels suggested by the manufacturers, ProGRP and neuron-specific enolase showed an almost identical sensitivity of 55.2% and 55.6%, respectively, in discriminating small cell lung cancer with respect to non-malignant lung disease. In order to quantify the added value of ProGRP to other conventional markers, we ran a multivariable logistic regression analysis, but the results showed that no markers improve the performance of ProGRP. CONCLUSIONS ProGRP and neuron-specific enolase individually appear more accurate than other conventional biomarkers for small cell lung cancer, but the union of two markers does not increase the accuracy. The very small target group of patients with small cell lung cancer is a limitation of this study, which can explain why ProGRP alone does not show a sensitivity higher than neuron-specific enolase, as reported by other authors.
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Affiliation(s)
- Cristian Mauro
- 1 Division of Laboratory Medicine, European Institute of Oncology, IRCCS, Milan, Italy
| | - Rita Passerini
- 1 Division of Laboratory Medicine, European Institute of Oncology, IRCCS, Milan, Italy
| | - Lorenzo Spaggiari
- 2 Division of Thoracic Surgery, European Institute of Oncology, IRCCS, Milan, Italy.,3 Department of Oncology and Hematology-Oncology-DIPO, University of Milan, Milan, Italy
| | - Domenico Galetta
- 2 Division of Thoracic Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Davide Radice
- 4 Division of Epidemiology and Biostatistics, European Institute of Oncology, IRCCS, Milan, Italy
| | - Paola Lentati
- 1 Division of Laboratory Medicine, European Institute of Oncology, IRCCS, Milan, Italy
| | - M Teresa Sandri
- 5 Division of Laboratory Medicine, Humanitas Clinical and Research Center, IRCCS, Rozzano Milan, Italy
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Choice of serum tumor markers in patients with small cell lung cancer: progastrin-releasing peptide, neuron-specific enolase, and carcinoembryonic antigen. JOURNAL OF BIO-X RESEARCH 2018. [DOI: 10.1097/jbr.0000000000000002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Wojcik E, Kulpa JK. Pro-gastrin-releasing peptide (ProGRP) as a biomarker in small-cell lung cancer diagnosis, monitoring and evaluation of treatment response. LUNG CANCER-TARGETS AND THERAPY 2017; 8:231-240. [PMID: 29238236 PMCID: PMC5716401 DOI: 10.2147/lctt.s149516] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Lung cancer belongs to malignant tumors that possess the highest rates of morbidity and mortality in the world. A number of morphological, biological and clinical features justify the distinction of small-cell carcinoma with respect to the other histological types of lung cancer. The predominant neuroendocrine phenotype is critical for the selection of biomarkers used in diagnostics, monitoring and evaluation of treatment response; early onset relapses in patients with small-cell lung cancer (SCLC) and the evaluation of their prognosis. Although for a long time the neuron-specific enolase (NSE) was considered to be the marker of choice for this tumor, it is now increasingly important to pay attention to concentrations of pro-gastrin-releasing peptide (ProGRP). The results of this marker have been implicated in the differential diagnosis of non-small lung cancer and SCLC, chemotherapy and radiotherapy monitoring as well as evaluation of treatment response. The subject of this series of studies is to determine the usefulness of ProGRP in the evaluation of patients’ prognosis and its predictive value. The current aim for the optimization of the effectiveness of biochemical diagnostics of SCLC is recommended by complementary ProGRP and NSE studies. The present work is a summary of the latest reports regarding diagnostic utility of these markers in SCLC.
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Affiliation(s)
- Ewa Wojcik
- Department of Clinical Biochemistry, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Cracow, Poland
| | - Jan Kanty Kulpa
- Department of Clinical Biochemistry, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Cracow, Poland
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9
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The Combination of the Tumor Markers Suggests the Histological Diagnosis of Lung Cancer. BIOMED RESEARCH INTERNATIONAL 2017; 2017:2013989. [PMID: 28607926 PMCID: PMC5451759 DOI: 10.1155/2017/2013989] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/28/2017] [Accepted: 04/24/2017] [Indexed: 11/30/2022]
Abstract
Tumor markers are beneficial for the diagnosis and therapy monitoring of lung cancer. However, the value of tumor markers in lung cancer histological diagnosis is unknown. In this study, we analyzed the serum levels of six tumor markers (CEA, CYFRA21-1, SCC, NSE, ProGRP, and CA125) in 2097 suspected patients with lung cancer and determined whether the combination of the tumor markers was useful for histological diagnosis of lung cancer. We found that CYFRA21-1 was the most sensitive marker in NSCLC. ProGRP showed a better clinical performance than that of NSE in discriminating between SCLC and NSCLC. The serum level of CYFRA21-1 or SCC was significantly higher in squamous carcinoma (p < 0.05), and the levels of ProGRP and NSE were significantly higher in SCLC (p < 0.05). According to the criteria established, SCLC and NSCLC were discriminated with sensitivity of 87.12 and 62.63% and specificity of 64.61 and 99.5%, respectively. The sensitivity and specificity in the differentiation of adenocarcinoma and squamous carcinoma were 68.1 and 81.63% and 70.73 and 65.93%, with NPV of 46.03 and 68.97% and PPV of 85.82 and 79.47%, respectively. Our results suggested the combination of six tumor markers could discriminate the histological types of lung cancer.
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10
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Automated Protein Biomarker Analysis: on-line extraction of clinical samples by Molecularly Imprinted Polymers. Sci Rep 2017; 7:44298. [PMID: 28303910 PMCID: PMC5355873 DOI: 10.1038/srep44298] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/26/2017] [Indexed: 12/30/2022] Open
Abstract
Robust biomarker quantification is essential for the accurate diagnosis of diseases and is of great value in cancer management. In this paper, an innovative diagnostic platform is presented which provides automated molecularly imprinted solid-phase extraction (MISPE) followed by liquid chromatography-mass spectrometry (LC-MS) for biomarker determination using ProGastrin Releasing Peptide (ProGRP), a highly sensitive biomarker for Small Cell Lung Cancer, as a model. Molecularly imprinted polymer microspheres were synthesized by precipitation polymerization and analytical optimization of the most promising material led to the development of an automated quantification method for ProGRP. The method enabled analysis of patient serum samples with elevated ProGRP levels. Particularly low sample volumes were permitted using the automated extraction within a method which was time-efficient, thereby demonstrating the potential of such a strategy in a clinical setting.
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11
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Parra-Robert M, Orois A, Augé JM, Halperin I, Filella X, Molina R. Utility of proGRP as a tumor marker in the medullary thyroid carcinoma. ACTA ACUST UNITED AC 2017; 55:441-446. [DOI: 10.1515/cclm-2016-0572] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 09/19/2016] [Indexed: 01/28/2023]
Abstract
AbstractBackground:Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor caused by a malignant transformation in the parafollicular C-cells of the thyroid, where calcitonin (CT) is released. Nowadays the main tumor markers (TM) used in the diagnosis and follow-up of MTC patients are CT and carcinoembryonic antigen (CEA). Nonetheless, progastrin releasing peptide (proGRP) has been recently proposed as a TM useful in the MTC. Our aims were to investigate the release of proGRP in thyroid tumors, its role in the assessment of advanced MTC and its utility in the differential diagnosis between MTC and non-MTC thyroid tumors.Methods:Serum samples from 22 patients with MTC and 16 with non-MTC were collected. Patients were classified into advanced cancer or no evidence of disease (NED). ProGRP was performed by Architect (Abbot Diagnostics), CT by Liaison (Diasorin) and CEA by Cobas E601(Roche Diagnostics).Results:ProGRP median concentration in advanced MTC was significantly higher (1398.4 pg/mL) when compared with non-MTC, either in advanced disease (24.9 pg/mL) or NED (14.6 pg/mL). In non-MTC patients, proGRP median concentration was below its cutoff level (50 pg/mL). Similar to CT, proGRP was able to detect 88.9% of MTC patients, but with a slightly lower specificity of 76.9%. Using proGRP together with CT the sensitivity increased to 100%.Conclusions:The low prevalence of this malignancy strongly recommends further collaborative studies, mainly focused on monitoring proGRP during tyrosine kinase inhibitors treatment for early detection of resistance and assessing its usefulness to avoid the observed false positive fluctuations that occur with CT and CEA.
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12
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Zhang X, Guo M, Fan J, Lv Z, Huang Q, Han J, Wu F, Hu G, Xu J, Jin Y. Prognostic significance of serum LDH in small cell lung cancer: A systematic review with meta-analysis. Cancer Biomark 2016; 16:415-23. [PMID: 27062698 DOI: 10.3233/cbm-160580] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lactare dehydrogenase (LDH) has been proven to be a prognostic and a potential pro-tumor factor in patients with lung cancer. But the prognostic value of serum LDH in small cell lung cancer (SCLC) has not been quantified systematically. OBJECTIVE Thus, this study was to evaluate the correlations between serum LDH and overall survival of SLCLC by systematic review with meta-analysis. METHODS PubMed, EMBASE, Cochrane Library, Web of Science databases were searched from inception to October 2014 and references in those publications would be included if the association between serum LDH and overall survival of SCLC can be derived. Quality assessment and data extraction were performed in the articles selected according to inclusion and exclusion criteria. RESULTS Twenty-eight studies including 4785 patients with SCLC were deemed eligible. Pooled results showed that SCLC patients with elevated LDH levels were associated with an increased hazard ratio (HR 1.45, 95%CI 1.27∼ 1.66) of overall survival. CONCLUSIONS The study suggests significant correlations between elevated serum LDH levels and poor overall survival in patients with SCLC. And serum LDH levels can be measured combining with other tools for assessing the risk stratification and prognosis of SCLC, which shows directions for treatments of SCLC.
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Affiliation(s)
- Xiuxiu Zhang
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Jining No.1 People's Hospital, Jining, Shandong, China
| | - Mengfei Guo
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jinshuo Fan
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhilei Lv
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qi Huang
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jieli Han
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Feng Wu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guorong Hu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Juanjuan Xu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yang Jin
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of Health Ministry, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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13
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Lee JE, Lee JH, Hong M, Park SK, Yu JI, Shin SY, Kim SY. Instability of Plasma and Serum Progastrin-Releasing Peptide During Repeated Freezing and Thawing. Osong Public Health Res Perspect 2016; 7:351-355. [PMID: 28053839 PMCID: PMC5194227 DOI: 10.1016/j.phrp.2016.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 11/10/2016] [Indexed: 12/04/2022] Open
Abstract
Objectives Progastrin-releasing peptide (proGRP) is a promising biomarker for small cell lung cancer. However, not much is known about how sample processing and storage conditions affect the stability of proGRP. Here, we examined the effects of repeated freeze–thaw cycles on the stability of proGRP in plasma and serum. Methods Concentrations of proGRP were measured in plasma and serum samples exposed to two, three, or four freeze–thaw cycles and these were compared with values of corresponding samples exposed to one cycle (baseline). We also performed the area under the receiver-operating-characteristic curve (AUC) analysis to determine whether the differences of proGRP concentrations between each paired plasma and serum sample (ΔproGRP) can be used for identifying the samples that have been exposed to multiple freeze–thaw cycles. Results Concentrations of proGRP gradually decreased in both plasma and serum samples with increasing numbers of freeze–thaw cycles. Reduction rates of proGRP concentrations were greater in serum than in plasma samples and serum proGRP levels declined with statistical significance (p < 0.001) up to 10.1% after four freeze–thaw cycles. The ΔproGRP measurement showed fair accuracy (AUC = 0.741) for identifying samples that had been through four freeze–thaw cycles. The sensitivity was 82.8% and specificity was 62.1% at an optimal cut-off point of > 4.9. Conclusion Our study shows that the stability of circulating proGRP is affected in both plasma and serum samples by repeated freezing and thawing. We also show that ΔproGRP could be used for identifying paired plasma and serum samples subjected to multiple freeze–thaw cycles.
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Affiliation(s)
- Jae-Eun Lee
- National Biobank of Korea, Center for Genome Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Jin-Hyun Lee
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Maria Hong
- National Biobank of Korea, Center for Genome Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Seul-Ki Park
- National Biobank of Korea, Center for Genome Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Ji-In Yu
- National Biobank of Korea, Center for Genome Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - So-Youn Shin
- National Biobank of Korea, Center for Genome Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea
| | - Shine Young Kim
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea
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14
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Oh HJ, Park HY, Kim KH, Park CK, Shin HJ, Lim JH, Kwon YS, Oh IJ, Kim YI, Lim SC, Kim YC, Kim SH, Shin MG. Progastrin-releasing peptide as a diagnostic and therapeutic biomarker of small cell lung cancer. J Thorac Dis 2016; 8:2530-2537. [PMID: 27747005 DOI: 10.21037/jtd.2016.08.72] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Progastrin-releasing peptide (proGRP) is a recently identified biomarker of small cell lung cancer (SCLC). We evaluated the usefulness of plasma proGRP level as a tumor marker for diagnosis and treatment monitoring in patients with SCLC. METHODS Plasma samples were collected prospectively from 452 [212 non-small cell lung cancer (NSCLC), 105 SCLC, and 135 other diseases] patients who visited the hospital for tissue diagnosis. Plasma proGRP levels were measured using a two-step automated immunoassay. RESULTS The median proGRP level was significantly higher in patients with SCLC (892.7 pg/mL) than those with NSCLC (32.6 pg/mL, P<0.001) and other diseases (26.6 pg/mL, P<0.001). At cutoff level of 63 pg/mL, proGRP shows 85.7% sensitivity, 90.2% specificity, 72.5% positive predictive value and 95.4% negative predictive value in patients with SCLC. The area under the curve values were 0.93 for distinguishing SCLC from NSCLC, and 0.943 for distinguishing SCLC from the other conditions. Median proGRP level was higher in extensive disease (1,055.2 pg/mL) than limited disease (253.8 pg/mL, P=0.005). Median OS was significantly shorter in patients with extensive disease (6.0±0.7 months) than limited disease (12.7±4.5 months, P<0.01). Among the 39 patients with SCLC who were followed, the median proGRP levels of the 23 responders decreased after chemotherapy (P<0.001). CONCLUSIONS Plasma proGRP level could be a useful diagnostic and therapeutic monitoring biomarker for patients with SCLC and the initial level may help with SCLC tumor staging.
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Affiliation(s)
- Hyung-Joo Oh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Ha-Young Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Ki-Hyun Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Cheol-Kyu Park
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea;; Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Korea
| | - Hong-Joon Shin
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jung-Hwan Lim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea;; Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Korea
| | - Yong-Soo Kwon
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - In-Jae Oh
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea;; Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Korea
| | - Yu-Il Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Chul Lim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young-Chul Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea;; Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Korea
| | - Soo-Hyun Kim
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Myung-Geun Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
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15
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Huang Z, Xu D, Zhang F, Ying Y, Song L. Pro-gastrin-releasing peptide and neuron-specific enolase: useful predictors of response to chemotherapy and survival in patients with small cell lung cancer. Clin Transl Oncol 2016; 18:1019-25. [PMID: 26886220 DOI: 10.1007/s12094-015-1479-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 12/29/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was (1) to evaluate and predict the value of ProGRP and NSE in therapy and survival; (2) as well as to investigate the correlation between the ProGRP mRNA expression in peripheral blood and serum ProGRP protein. METHODS The study included 122 patients with SCLC without prior therapy. The serum levels of ProGRP and NSE were detected by enzyme-linked immunosorbent assay and eletro-chemiluminescence immunoassay, respectively. The expression of ProGRP mRNA was detected by real-time reverse transcriptase-polymerase chain reaction. RESULTS Distribution of serum levels of ProGRP, NSE and ProGRP mRNA differed significantly according to tumor size, disease stage and distant metastasis (all P < 0.05), and no association was found between them and gender or age (both P > 0.05). After two courses of chemotherapy, patients of remission and stable groups showed a marked decrease in ProGRP and NSE concentrations (P < 0.05). The ProGRP concentration of patients in progression group was significantly higher than pretreatment level (P < 0.05), while NSE concentration was not. A linear nonparametric (Spearman) correlation test revealed that there was a significant correlation between ProGRP mRNA expression in peripheral blood and serum ProGRP protein level (P < 0.05). Univariate analysis found a statistically significant association of survival with disease stage, distant metastasis, ProGRP and NSE (P < 0.05). Gender, age and tumor size were not prognostic factors (P > 0.05). Multiple Cox regression model analysis found that only disease stage and NSE were significant predictors (P < 0.05). CONCLUSIONS This study has found that there is a potential role for ProGRP and NSE in both therapy monitoring and predicting survival in SCLC patients.
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Affiliation(s)
- Z Huang
- Department of Internal Medicine Oncology, Shandong Cancer Hospital and Institute, No. 440 Jiyan Road, Jinan, 250117, China.,Shandong Academy of Medical Sciences, School of Medicine and Life Sciences, University of Jinan, Jinan, China
| | - D Xu
- Department of Internal Medicine Oncology, Shandong Cancer Hospital and Institute, No. 440 Jiyan Road, Jinan, 250117, China.,Shandong Academy of Medical Sciences, School of Medicine and Life Sciences, University of Jinan, Jinan, China.,Department of Medical Oncology II, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan, China
| | - F Zhang
- Department of Internal Medicine Oncology, Shandong Cancer Hospital and Institute, No. 440 Jiyan Road, Jinan, 250117, China.,Shandong Academy of Medical Sciences, School of Medicine and Life Sciences, University of Jinan, Jinan, China
| | - Y Ying
- Department of Internal Medicine Oncology, Shandong Cancer Hospital and Institute, No. 440 Jiyan Road, Jinan, 250117, China.,Shandong Academy of Medical Sciences, School of Medicine and Life Sciences, University of Jinan, Jinan, China
| | - L Song
- Department of Internal Medicine Oncology, Shandong Cancer Hospital and Institute, No. 440 Jiyan Road, Jinan, 250117, China.
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Molina R, Marrades RM, Augé JM, Escudero JM, Viñolas N, Reguart N, Ramirez J, Filella X, Molins L, Agustí A. Assessment of a Combined Panel of Six Serum Tumor Markers for Lung Cancer. Am J Respir Crit Care Med 2016; 193:427-37. [DOI: 10.1164/rccm.201404-0603oc] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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17
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Rossetti C, Abdel Qader A, Halvorsen TG, Sellergren B, Reubsaet L. Antibody-Free Biomarker Determination: Exploring Molecularly Imprinted Polymers for Pro-Gastrin Releasing Peptide. Anal Chem 2014; 86:12291-8. [DOI: 10.1021/ac503559c] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Cecilia Rossetti
- Department
of Pharmaceutical Chemistry, School of Pharmacy, University of Oslo, NO-0316 Oslo, Norway
| | - Abed Abdel Qader
- Department
of Environmental Chemistry and Analytical Chemistry,
Institute for Environmental Research (INFU), Technical University of Dortmund, D-44221 Dortmund, Germany
| | - Trine Grønhaug Halvorsen
- Department
of Pharmaceutical Chemistry, School of Pharmacy, University of Oslo, NO-0316 Oslo, Norway
| | - Börje Sellergren
- Department
of Environmental Chemistry and Analytical Chemistry,
Institute for Environmental Research (INFU), Technical University of Dortmund, D-44221 Dortmund, Germany
- Department
of Biomedical Sciences, Faculty of Health and Society, University of Malmö, 205 06 Malmö, Sweden
| | - Léon Reubsaet
- Department
of Pharmaceutical Chemistry, School of Pharmacy, University of Oslo, NO-0316 Oslo, Norway
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18
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Determining ProGRP and isoforms in lung and thyroid cancer patient samples: comparing an MS method with a routine clinical immunoassay. Anal Bioanal Chem 2014; 406:2733-8. [PMID: 24518900 DOI: 10.1007/s00216-014-7634-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 12/20/2013] [Accepted: 01/16/2014] [Indexed: 10/25/2022]
Abstract
This paper compares two methods to determine the tumor marker progastrin-releasing peptide (ProGRP): as routine assay, the automated time-resolved immunofluorometric assay (TR-IFMA), which allows total ProGRP determination; and the immunocapture liquid chromatography selected reaction monitoring mass spectrometry (LC-SRM-MS) method, which additionally allows isoform differentiation. The investigation included 60 serum samples from patients suffering from various cancer diseases which may cause elevated ProGRP levels (small cell lung carcinoma; SCLC, non-small cell lung carcinoma; NCLC; and medullary thyroid cancer; MTC, as well as some with unspecific diagnosis). The two methods showed good correlation (R (2) = 0.887). However, the MS method determines the total ProGRP concentration systematically approximately 30 % lower than the TR-IFMA, implying that the absolute values generated by the methods are not interchangeable. The MS method gives additional information about isoform levels in the samples, providing novel insight into isoform expression on the protein level.
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19
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The prognostic significance of the circulating neuroendocrine markers chromogranin A, pro-gastrin-releasing peptide, and neuron-specific enolase in patients with small-cell lung cancer. Med Oncol 2013; 31:823. [PMID: PMID: 24375395 DOI: 10.1007/s12032-013-0823-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 12/17/2013] [Indexed: 10/25/2022]
Abstract
Lung cancer is the most common cancer, and small-cell lung cancer (SCLC) accounts for around 20 % of lung cancers. SCLC has a neuroendocrine cellular origin, and the tumor cells usually express neuroendocrine markers. There have been major recent advances in the management of SCLC, and multimodal approaches are now the norm. An improved knowledge of the prognostic variables would assist in defining which patients were better candidates to receive these newer intensive therapies. This single-center retrospective study of 97 previously untreated and histologically proven SCLC patients analysed the circulating neuroendocrine markers chromogranin A (CGA), pro-gastrin-releasing peptide (ProGRP), and neuron-specific enolase (NSE) in addition to the other more classical variables. Fifty patients had limited-stage disease and 47 had extensive disease. Sixty patients had an ECOG performance status (PS) of 0-1 and 37 had PS 2-4. Median survival for the whole study population was 13 months. Univariate analysis and univariate Cox regression modeling found a statistically significant association between survival and PS, disease stage, and CGA, ProGRP, and NSE levels. Age and sex were not prognostic. A shorter survival time was found in patients with a PS equal to or >2, extensive stage disease, a serum CGA level >56 ng/ml, a serum ProGRP level >58 pg/ml, and a serum NSE level >19 ng/ml. This study has found that there is a potential role for ProGRP, NSE, and CGA in both staging and prognosing survival in SCLC patients.
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Serum markers in small cell lung cancer: opportunities for improvement. Biochim Biophys Acta Rev Cancer 2013; 1836:255-72. [PMID: 23796706 DOI: 10.1016/j.bbcan.2013.06.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 06/11/2013] [Accepted: 06/13/2013] [Indexed: 12/11/2022]
Abstract
Lung cancer is one of the leading causes of death from malignancy worldwide. In particular small cell lung cancers, which comprise about 15-20% of all lung cancers, are extremely aggressive and cure rates are extremely low. Therefore, new treatment modalities are needed and detection at an early stage of disease, as well as adequate monitoring of treatment response is essential in order to improve outcome. In this respect, the use of non-invasive tools for screening and monitoring has gained increasing interest and the clinical applicability of reliable, tumor-related substances that can be detected as tumor markers in easily accessible body fluids is subject of intense investigation. Some of these indicators, such as high LDH levels in serum as a reflection of the disease, have been in use for a long time as a general tumor marker. To allow for improved monitoring of the efficacy of new therapeutic modalities and for accurate subtyping, there is a strong need for specific and sensitive markers that are more directly related to the biology and behavior of small cell lung cancer. In this review the current status of these potential markers, like CEA, NSE, ProGRP, CK-BB, SCC, CgA, NCAM and several cytokeratins will be critically analyzed with respect to their performance in blood based assays. Based on known cleavage sites for cytoplasmic and extracellular proteases, a prediction of stable fragments can be obtained and used for optimal test design. Furthermore, insight into the synthesis of specific splice variants and neo-epitopes resulting from protein modification and cleavage, offers further opportunities for improvement of tumor assays. Finally, we discuss the possibility that detection of SCLC related autoantibodies in paraneoplastic disease can be used as a very early indicator of SCLC.
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Nordlund MS, Stieber P, Brustugun OT, Warren DJ, Paus E. Characteristics and clinical validity of two immunoassays for ProGRP. Tumour Biol 2012; 33:1105-13. [PMID: 22399443 DOI: 10.1007/s13277-012-0351-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 02/08/2012] [Indexed: 10/28/2022] Open
Abstract
Progastrin-releasing peptide (proGRP) is a promising serum tumor marker for small cell lung cancer (SCLC). We have tested assay specificity and performed a correlation study between a recently developed time-resolved immunofluorometric assay (TR-IFMA) for proGRP and the established Advanced Life Science Institute (ALSI) ELISA method. Between-method correlation and comparison of clinical performance were studied in 481 individuals, among them, 178 lung cancers, 84 benign diseases of the lung, and 219 healthy controls. Follow-up time >6 years was observed for 89 patients with SCLC. The two assays had quite different epitope specificities where the TR-IFMA recognized a considerable smaller proGRP fragment than the ALSI ELISA. However, the correlation between the two methods for elevated proGRP values (>85 ng/l) was good (ρ = 0.948). Both assays displayed good discrimination between benign lung diseases and SCLC. The cut-off values for positive classification of SCLC versus non-small cell lung cancers and benign lung diseases at >95% specificity were 85 ng/l for the TR-IFMA and 42 ng/l for the ALSI ELISA. Both proGRP assays showed good clinical validity. However, due to differences in the recommended cut-off values, switching methods is not recommended. There was a significant difference in survival of patients with TR-IFMA proGRP values over the cut-off (85 ng/l) compared with patients with values under the cut-off, p = 0.0002. In contrast, the ALSI ELISA assay failed to provide statistically significant prognostic information, p = 0.066.
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Affiliation(s)
- Marianne S Nordlund
- Department of Medical Biochemistry, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
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Ono A, Naito T, Ito I, Watanabe R, Shukuya T, Kenmotsu H, Tsuya A, Nakamura Y, Murakami H, Kaira K, Takahashi T, Kameya T, Nakajima T, Endo M, Yamamoto N. Correlations between serial pro-gastrin-releasing peptide and neuron-specific enolase levels, and the radiological response to treatment and survival of patients with small-cell lung cancer. Lung Cancer 2012; 76:439-44. [PMID: 22300752 DOI: 10.1016/j.lungcan.2011.12.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 12/22/2011] [Accepted: 12/24/2011] [Indexed: 11/18/2022]
Abstract
INTRODUCTION To investigate whether decrease in the serum levels of pro-gastrin releasing peptide (ProGRP) and neuron-specific enolase (NSE) were correlated with the radiological response in patients with small-cell lung cancer (SCLC). METHODS Of the 196 patients, we retrospectively reviewed 118 patients elevated baseline levels of ProGRP and NSE prior to the initial therapy (IT) who survived for more than 1 month. The radiological response was assessed by Response Evaluation Criteria in Solid Tumors (RECIST 1.1). RESULTS Decrease in the serum ProGRP was strongly correlated with the decrease of the sum of the tumor diameters (SOD) before the third course (ρ=0.50) and after the fourth course (ρ=0.42) of IT. Decrease in the serum NSE was weakly correlated with the decrease of the SOD after the fourth course (ρ=0.27), but not before the third courses (ρ=0.22). In the receiver operating characteristic (ROC) curves predicting 1-year survivors, the area under the curve (AUC) for percent changes in serum ProGRP before the third course were significantly larger than those for NSE (0.714 vs. 0.527, p=0.004). CONCLUSIONS Percent changes in serum ProGRP showed better correlation to SOD and prognostic impact than that of NSE.
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Affiliation(s)
- Akira Ono
- Shizuoka Cancer Center, Division of Thoracic Oncology, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan
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Korse C, Taal B, Bonfrer J, Vincent A, van Velthuysen M, Baas P. An elevated progastrin-releasing peptide level in patients with well-differentiated neuroendocrine tumours indicates a primary tumour in the lung and predicts a shorter survival. Ann Oncol 2011; 22:2625-2630. [DOI: 10.1093/annonc/mdr007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Xue X, Xue Q, Wang N, Zhang L, Guo L, Li X, Sun J, Wang J. Early clinical diagnosis of synchronous multiple primary lung cancer. Oncol Lett 2011; 3:234-237. [PMID: 22740887 DOI: 10.3892/ol.2011.452] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 10/11/2011] [Indexed: 11/05/2022] Open
Abstract
The diagnosis of synchronous multiple primary lung cancer (SMPLC) remains a formidable challenge. The aim of the present study was to identify useful clues for the clinical diagnosis of SMPLC, in particular for the early stages. The medical records of 10 patients diagnosed with SMPLC with different histological types were analyzed retrospectively. Chest computed tomography (CT) findings showed two pulmonary lesions in all patients. The two lesions displayed malignant characteristics of primary lung cancer. The levels of a number of tumor markers, including carcinoembryonic antigen, neuron-specific enolase, cytokeratin fragment 21-1, squamous cell carcinoma and CA125 increased in 2 patients. Auxiliary examinations of other physical sites in these patients did not show signs of neoplasm metastasis. Two tumors were separately staged and appropriate treatment was carried out based on the revised stage, which provided more benefits for SMPLC patients. The diagnosis of SMPLC might be delayed or mistaken owing to its similarity to neoplasm metastasis. A high index of awareness is required for the early diagnosis of this disease. The malignant characteristics of primary lung cancer in various lesions may be valuable clues for the diagnosis of SMPLC. Alterations in the levels of tumor markers may be a poor diagnostic tool for the detection of SMPLC. Separate biopsies for different pulmonary masses should be performed for clinical staging as soon as possible and reasonable treatment based on the stage should also be selected.
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Affiliation(s)
- Xinying Xue
- The Respiratory Diseases Department of the Chinese PLA General Hospital, Beijing 100853, P.R. China
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25
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Korse CM, Taal BG, Vincent A, van Velthuysen MLF, Baas P, Buning-Kager JCGM, Linders TC, Bonfrer JMG. Choice of tumour markers in patients with neuroendocrine tumours is dependent on the histological grade. A marker study of Chromogranin A, Neuron specific enolase, Progastrin-releasing peptide and cytokeratin fragments. Eur J Cancer 2011; 48:662-71. [PMID: 21945100 DOI: 10.1016/j.ejca.2011.08.012] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Revised: 08/01/2011] [Accepted: 08/15/2011] [Indexed: 12/15/2022]
Abstract
BACKGROUND Chromogranin A (CgA) is the most important tumour marker for well-differentiated neuroendocrine tumours (NET) and neuron specific enolase (NSE) for poorly differentiated neuroendocrine carcinoma (NEC). This study investigated whether the markers progastrin-releasing peptide (proGRP) and cytokeratin fragments (CKfr) CK8, CK18 and CK19 (MonoTotal) can be of additional value to the histological classification and help predict survival in these patients. METHODS CgA, NSE, proGRP and CKfr were measured in 242 patients with grade 1 NET (G1NET), 38 with grade 2 NET (G2NET), 42 with large cell NEC (LCNEC), 251 with small cell NEC (SCNEC) and in 282 healthy persons. Results were compared with tumour characteristics and survival by means of Receiver Operating Characteristics (ROC) curves and Cox regression analyses. RESULTS The largest area under the ROC curve was for CgA (0.86, 0.91 and 0.90, respectively) when comparing patients with G1NET, G2NET and LCNEC with healthy persons. ProGRP showed the highest sensitivity (73%) at 95% specificity in patients with SCNEC. In a multivariate survival analysis, only CKfr was associated with survival (P<0.0001) for patients with well-differentiated NET (G1NET and G2NET). For patients with poorly differentiated NEC, both CKfr and NSE were associated with survival (P<0.0001 and P=0.003, respectively). CONCLUSION Within all histological groups a combination of tumour markers proved to be more informative as diagnostic and prognostic marker than each marker alone. In patients with well-differentiated NET and LCNEC we recommend the use of CgA and CKfr, whilst in patients with SCNEC, proGRP and CKfr are preferred.
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Affiliation(s)
- Catharina M Korse
- Department of Clinical Chemistry, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, The Netherlands.
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26
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Kim HR, Oh IJ, Shin MG, Park JS, Choi HJ, Ban HJ, Kim KS, Kim YC, Shin JH, Ryang DW, Suh SP. Plasma proGRP concentration is sensitive and specific for discriminating small cell lung cancer from nonmalignant conditions or non-small cell lung cancer. J Korean Med Sci 2011; 26:625-30. [PMID: 21532852 PMCID: PMC3082113 DOI: 10.3346/jkms.2011.26.5.625] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Accepted: 03/07/2011] [Indexed: 11/20/2022] Open
Abstract
To date, most clinical data on pro-gastrin-releasing peptide (proGRP) have been based on serum concentrations. This study evaluated the agreement between proGRP levels in fresh serum and plasma in patients with various lung diseases. Pairs of serum and EDTA plasma were collected from 49 healthy individuals. At the same time, EDTA plasma of 118 lung cancer patients and 23 patients with benign pulmonary diseases were prospectively collected. Compared to serum, plasma proGRP concentrations were higher by an average of 103.3%. Plasma proGRP was higher in malignancy (336.4 ± 925.4 pg/mL) than in benign conditions (40.1 ± 11.5 pg/mL). Small cell lung cancer (SCLC) patients showed higher levels of proGRP (1,256.3 ± 1,605.6 pg/mL) compared to other types of lung cancer. Based on the ROC curve analyses at a specificity of 95%, the diagnostic sensitivity of plasma proGRP was estimated to be 83.8% in distinguishing SCLC from all the other conditions, and 86.5% for discriminating SCLC from the nonmalignant cases. Among the SCLC cases, limited stage disease had lower levels of plasma proGRP than extensive disease. When measuring circulating levels of proGRP, the use of plasma is preferred over serum. Plasma proGRP has a potential marker for discriminating SCLC from nonmalignant conditions or non-small cell lung cancer.
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Affiliation(s)
- Hye-Ran Kim
- Brain Korea 21 Project, Center for Biomedical Human Resources, Chonnam National University, Gwangju, Korea
| | - In-Jae Oh
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Myung-Geun Shin
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | | | - Hyun-Jung Choi
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Hee-Jung Ban
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Kyu-Sik Kim
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Young-Chul Kim
- Department of Internal Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Jong-Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Dong-Wook Ryang
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
| | - Soon-Pal Suh
- Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea
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Zhao X, Wang M. [Clinical utility of serum tumor markers in lung cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2011; 14:286-91. [PMID: 21426676 PMCID: PMC5999651 DOI: 10.3779/j.issn.1009-3419.2011.03.16] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Lung cancer shows a tendency of higher incidence and higher mortality in recent years, but the overall 5-year survival rate is less than 15%. Serum tumor markers of lung cancer play an important role in early diagnosis, determining of pathology types, staging, evaluation of response, and prognosis of lung cancer. In this review, 6 most important markers were reviewed, including neuron-specific enolase (NSE), pro-gastrin-releasing peptide (ProGRP), cytokeratin 19 fragments (Cyfra 21-1), tissue polypeptide antigen (TPA), squamous cell carcinoma associated antigen (SCC-Ag), carcinoembryonic antigen (CEA).
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Affiliation(s)
- Xiao Zhao
- Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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28
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Hirose T, Okuda K, Yamaoka T, Ishida K, Kusumoto S, Sugiyama T, Shirai T, Ohnshi T, Ohmori T, Adachi M. Are levels of pro-gastrin-releasing peptide or neuron-specific enolase at relapse prognostic factors after relapse in patients with small-cell lung cancer? Lung Cancer 2011; 71:224-8. [DOI: 10.1016/j.lungcan.2010.05.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 04/15/2010] [Accepted: 05/04/2010] [Indexed: 10/19/2022]
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Kumar S, Guleria R, Singh V, Bharti AC, Mohan A, Das BC. Plasma nucleosome levels might predict response to therapy in patients with advanced non-small-cell lung cancer. Clin Lung Cancer 2010; 11:36-44. [PMID: 20085866 DOI: 10.3816/clc.2010.n.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Recent progress in the field of anticancer drug discovery has created many options for improving the survival of patients with cancer. However, more effective diagnostic tools indicating early therapeutic efficacy or disease progression are still needed to improve the management of patients with inoperable cancer. PATIENTS AND METHODS Plasma nucleosome levels were quantified in 134 patients with advanced non-small-cell lung cancer before the first cycle of chemotherapy. It was also evaluated before the second and third cycles of chemotherapy in 42 patients receiving first-line chemotherapy. Nucleosomes were correlated with response to therapy as assessed by computed tomography after the third therapy cycle. RESULTS Patients who went into remission had significantly lower nucleosome levels before therapy cycles 2 and 3 than patients with no change or progression. High levels and insufficient decreases in nucleosome levels during the course of chemotherapy indicated poor outcome. Nucleosome levels before the second cycle detected poor response to therapy with a sensitivity and specificity of 69.2% and 75%, respectively (area under the receiver operating characteristic [ROC] curve, 0.816). Early prediction of disease progression was achieved with a sensitivity and specificity of 85.7% and 92.9%, respectively, for nucleosome levels before cycle 2 (area under the ROC curve, 0.930). CONCLUSION The monitoring of plasma nucleosome levels during the course of first-line chemotherapy could identify patients who are likely to have insufficient response to therapy and disease progression at an early stage. This might help in individualizing treatment and could lead to better management of advanced-stage lung cancer.
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Affiliation(s)
- Sachin Kumar
- Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Holdenrieder S, von Pawel J, Dankelmann E, Duell T, Faderl B, Markus A, Siakavara M, Wagner H, Feldmann K, Hoffmann H, Raith H, Nagel D, Stieber P. Nucleosomes, ProGRP, NSE, CYFRA 21-1, and CEA in monitoring first-line chemotherapy of small cell lung cancer. Clin Cancer Res 2009; 14:7813-21. [PMID: 19047109 DOI: 10.1158/1078-0432.ccr-08-0678] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Besides new therapeutic drugs, effective diagnostic tools indicating early the efficacy of therapy are required to improve the individual management of patients with nonoperable cancer diseases. EXPERIMENTAL DESIGN In prospectively collected sera of 128 patients with newly diagnosed small cell lung cancer receiving first-line chemotherapy, the courses of nucleosomes, progastrin-releasing peptide (ProGRP), neuron-specific enolase (NSE), cytokeratin-19 fragments (CYFRA 21-1), and carcinoembryonic antigen were investigated and correlated with therapy response objectified by computed tomography before start of the third treatment course. RESULTS In univariate analyses, high levels and insufficient decreases of nucleosomes, ProGRP, NSE, and CYFRA 21-1 during the first and second cycles of therapy correlated with poor outcome. Insufficient response to therapy was most efficiently indicated by the baseline values of nucleosomes, ProGRP, and CYFRA 21-1 before the second therapy cycle reaching areas under the curve (AUC) of 81.8%, 71.3%, and 74.9% in receiver operating characteristic curves, respectively. Combinations of nucleosomes with ProGRP (AUC 84.1%), CYFRA 21-1 (AUC 82.5%), and NSE (AUC 83.6%) further improved the diagnostic power in the high specificity range and yielded sensitivities of 47.1%, 35.3%, and 35.3% at 95% specificity, respectively. In multivariate analyses, including clinical and biochemical variables, only performance score and nucleosomes before cycle 2 were found to independently indicate therapy response. CONCLUSIONS Biochemical markers specifically identified patients with insufficient therapy response at the early treatment phase and showed to be valuable for diseases management of small cell lung cancer.
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Affiliation(s)
- Stefan Holdenrieder
- Institute of Clinical Chemistry, University Hospital Munich, Munich, Germany.
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Abstract
All forms of the neuropeptide gastrin-releasing peptide (GRP) are derived from the precursor proGRP1-125. Amidated GRP18-27, which together with amidated GRP1-27 was long thought to be the only biologically relevant product of the GRP gene, is involved in a multitude of physiological functions and acts as a mitogen, morphogen, and proangiogenic factor in certain cancers. Recently, GRP has been implicated in several psychiatric conditions, in the maintenance of circadian rhythm, in spinal transmission of the itch sensation, and in inflammation and wound repair. The actions of GRP are mediated by the GRP receptor. Over the last decade, nonamidated peptides derived from proGRP, such as the glycine-extended form GRP18-28 and recombinant and synthetic fragments from proGRP31-125, have been shown to be biologically active in a range of tissues and in cancer cell lines. While GRP18-28 acts via the GRP receptor, the identity of the receptor for proGRP31-125 and its fragments has not yet been established. Nonamidated fragments are also present in normal tissues and in various cancers. In fact, proGRP31-98 is the most sensitive serum biomarker in patients with small cell lung cancer and is a significant predictor of poor survival in patients with advanced prostate cancer.
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Affiliation(s)
- Joseph Ischia
- Department of Surgery, University of Melbourne, Austin Health, Melbourne, Victoria, Australia
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Rubins J, Unger M, Colice GL. Follow-up and surveillance of the lung cancer patient following curative intent therapy: ACCP evidence-based clinical practice guideline (2nd edition). Chest 2007; 132:355S-367S. [PMID: 17873180 DOI: 10.1378/chest.07-1390] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND To develop an evidence-based approach to follow-up of patients after curative intent therapy for lung cancer. METHODS Guidelines on lung cancer diagnosis and management published between 2002 and December 2005 were identified by a systematic review of the literature, and supplemental material appropriate to this topic was obtained by literature search of a computerized database (Medline) and review of the reference lists of relevant articles. RESULTS Adequate follow-up by the specialist responsible for the curative intent therapy should be ensured to manage complications related to the curative intent therapy and should last at least 3 to 6 months. In addition, a surveillance program should be considered to detect recurrences of the primary lung cancer and/or development of a new primary lung cancer early enough to allow potentially curative retreatment. A standard surveillance program for these patients, coordinated by a multidisciplinary tumor board and overseen by the physician who diagnosed and initiated therapy for the original lung cancer, is recommended based on periodic visits with chest imaging studies and counseling patients on symptom recognition. Smoking cessation and, if indicated, facilitation in participation in special programs is recommended for all patients following curative intent therapy for lung cancer. CONCLUSIONS The current evidence favors follow-up of complications related to curative intent therapy, and a surveillance program at regular intervals with imaging and review of symptoms. Smoking cessation after curative intent therapy to prevent recurrence of lung cancer is strongly supported by the available evidence.
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Affiliation(s)
- Jeffrey Rubins
- Pulmonary 111N, One Veterans Dr, Minneapolis, MN 55417, USA.
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Guo CB, Wang S, Deng C, Zhang DL, Wang FL, Jin XQ. Relationship between matrix metalloproteinase 2 and lung cancer progression. Mol Diagn Ther 2007; 11:183-92. [PMID: 17570740 DOI: 10.1007/bf03256240] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND OBJECTIVE Matrix metalloproteinases (MMPs) play an important role in several steps of cancer development. MMP2 and MMP9 have previously been implicated in lymphatic and vascular invasion of lung cancer; however, the expression and prognostic significance of MMP2 and MMP9 is not fully clarified. This study was designed to investigate the significance of MMP2 and MMP9 in lung cancer tissue or serum, and their correlation with lung cancer prognosis. METHODS Immunohistochemical analysis was performed to determine MMP2 and MMP9 staining in human nonsmall cell lung cancer (NSCLC). Serum MMP2 and MMP9 protein levels in patients after surgery were measured using the ELISA method. The correlation between MMP2 and MMP9 serum levels and clinicopathological features of NSCLC were analyzed by survival analysis. We also performed reverse transcriptase (RT)-PCR assays to detect messenger RNA (mRNA) expression to further confirm the activity of MMP2 and MMP9 in human lung cancer. RESULTS Increased MMP2 immunostaining and MMP2 serum level correlated with advanced tumor stage and the presence of distant metastasis (Pearson's chi(2) test and ANOVA, p < 0.05). However, for MMP9, only serum level showed a correlation with advanced tumor stage. No significant correlation was observed between MMP2 or MMP9 immunostaining expression and tumor histologic features (Pearson's chi(2) test, p = 0.061 and p = 0.087, respectively). A high densitometry value of MMP2 and MMP9 PCR products (i.e. mRNA expression level) was related to poor differentiation grade, distant metastasis, and small cell carcinoma histologic type (ANOVA, p < 0.05). CONCLUSIONS Our results suggest that MMP2 is a more sensitive predictor than MMP9 of lung cancer progression, metastasis, and survival. Serum MMP2 levels may be a valuable prognosis variable and could help to stratify lung cancer patients into low- and high-risk groups.
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Affiliation(s)
- Chun-Bao Guo
- Laboratory of Surgery, Children's Hospital of Chongqing Medical University, Chongqing, Peoples Republic of China
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Winther B, Moi P, Paus E, Reubsaet JLE. Targeted determination of the early stage SCLC specific biomarker pro-gastrin-releasing peptide (ProGRP) at clinical concentration levels in human serum using LC-MS. J Sep Sci 2007; 30:2638-46. [PMID: 17874417 DOI: 10.1002/jssc.200700221] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Pro-gastrin-releasing peptide (ProGRP) is used as a specific diagnostic marker for small cell lung cancer (SCLC), a rapidly growing neoplasm with high mortality. Our object was to develop an LC-MS method for the detection and quantification of ProGRP in human serum using the specific tryptic digestion product NLLGLIEAK (m/z 485.8 for [M + 2H](2+)). For this purpose the sample pretreatment, clean-up, enrichment, and LC-MS conditions were evaluated. Sample pretreatment was carried out using ACN precipitation to decrease the sample complexity. Although ProGRP (31-98) standards were soluble in 99% ACN, it showed that optimal signal intensities were obtained by adding ACN to the serum in a 1:1 ratio v/v. A simplified tryptic digest protocol was carried out using 100 mM triethanolamine buffer to ensure pH stability during the whole procedure. The simplified protocol also includes omission of reducing and alkylating reagents. Necessary additional sample clean-up was achieved by trapping NLLGLIEAK on a RAM column (ADS-C8) which was back-flushed onto the analytical BioBasic C8 column. Volume of injection, sample enrichment, and column capacity are among the factors optimized to reach a mass LOD of 150 pg on column (OC) ProGRP (31-98). Detection of ProGRP in the serum sample of a patient suffering from SCLC with a clinically relevant concentration shows the potential of the method in diagnosis, prognosis, and monitoring of the disease.
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Affiliation(s)
- Bjørn Winther
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Oslo, Oslo, Norway.
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35
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Satoh H, Kagohashi K, Kurishima K, Ishikawa H, Ohtsuka M. Comparison of neurone-specific enolase and pro-gastrin releasing peptide in the prognostic evaluation of small cell lung cancer patients. Clin Oncol (R Coll Radiol) 2007; 18:720. [PMID: 17100161 DOI: 10.1016/j.clon.2006.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Winther B, Reubsaet JL. Determination of the small cell lung cancer associated biomarker pro-gastrin-releasing peptide (ProGRP) using LC-MS. J Sep Sci 2007; 30:234-40. [PMID: 17390617 DOI: 10.1002/jssc.200600319] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Small cell lung cancer is a rapidly growing neoplasm with high mortality. A recently discovered biomarker, pro-gastrin-releasing peptide (ProGRP), is used as a specific diagnostic marker for the disease. The present methods of quantification are based on the immunoassay techniques RIA and ELISA. Our object was to develop an LC-MS method for the detection and quantification of ProGRP using specific tryptic digestion products from the recombinant peptide ProGRP (31-98), a sequence common to three isoforms of ProGRP. The conditions for enzymatic cleavage were optimized and MS compatibility was obtained. Digestion of ProGRP (31-98) yielded an array of peptide products and these were evaluated for further method development. The peptide product NLLGLIEAK proved to be the preferable candidate to monitor ProGRP due to signal intensity, column retention, and peptide specificity. The identity of this product was verified by means of LC-MS/MS and the linearity of the calibration curve evaluated. LOD was calculated to be 13.9 pg on column (O.C.). Plasma samples spiked with ProGRP (31-98) prior to digestion verified the suitability of this digest product for the determination of ProGRP. LC-MS may prove to be a valuable tool for biomarker mediated diagnosis in the future.
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Affiliation(s)
- Bjørn Winther
- Department of Pharmaceutical Chemistry, School of Pharmacy, University of Oslo, Oslo, Norway.
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Yamaguchi H, Soda H, Kitazaki T, Nakano H, Fujino S, Nakamura Y, Kohno S. Serum progastrin-releasing peptide levels followed by whole-body positron emission tomography detects early recurrence of small-cell lung cancer. Respirology 2007; 12:137-9. [PMID: 17207039 DOI: 10.1111/j.1440-1843.2006.00966.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 65-year-old male smoker with severe COPD was diagnosed with limited-stage small-cell lung cancer. After receiving cisplatin/irinotecan, serum progastrin-releasing peptide (ProGRP) levels decreased to within the reference values and the lesions were markedly reduced in size. A whole-body 18F-fluorodeoxyglucose PET (FDG-PET) scan confirmed complete remission. During follow up, serum ProGRP levels increased, and a whole-body FDG-PET scan detected recurrence at the hilar lymph node that had been negative on CT. Complete remission was again achieved with second-line chemotherapy (cisplatin/etoposide) and local irradiation to the hilar lymph node. Monitoring serum ProGRP levels, followed by whole-body FDG-PET when indicated, may improve the clinical management of patients with small-cell lung cancer after initial complete remission.
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Affiliation(s)
- Hiroyuki Yamaguchi
- Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
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Recommendations For Clinical Use Of Tumor Markers In Lung Cancer. J Med Biochem 2007. [DOI: 10.2478/v10011-007-0016-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Preporuke Za Primenu Tumorskih Markera Kod Kancera PlućaKancer pluća predstavlja jedan od najozbiljnijih problema moderne onkologije. Uprkos kontinuiranom napretku u dijagnostičkim metodama, kod 50-70% pacijenata s kancerom pluća, bolest se dijagnostikuje u uznapredovalom stadijumu, isključujuci na taj način mogućnost radikalne terapije. Određivanje tumorskih markera kod kancera pluća može biti od pomoći u postavljanju dijagnoze, praćenju pacijenta i terapije, a takođe može da pruži dodatne informacije u prognostičke svrhe. U daljem tekstu opisani su odgovarajući serumski markeri kod dve glavne forme tumora pluća-mikrocelularnog i nemikrocelularnog (SCLC i NSCLC), kao i abnormalne supstance identifikovane u tumorima pluća ili njihovim metastazama, kao što su molekularni markeri, markeri prognoze u primeni neoadjuvantne ili adjuvantne terapije i mikrometastazama koštane srži ili limfnom čvoru.
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Lung Cancer - Clinical Implications. J Med Biochem 2007. [DOI: 10.2478/v10011-007-0015-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Karcinom Pluća - Kliničke ImplikacijeKarcinom pluća je najčešće maligno oboljenje kod muškog pola, a u žena na drugom mestu (nakon raka dojke). Klinička podela na nemikrocelularni (NSCLC) i mikrocelularni (SCLC) odražava različito biološko ponašanje i sledstveno razlike u terapijskom pristupu. Od velike važnosti bi bilo postojanje biomarkera koji bi omogućili razlikovanje ova dva tipa karcinoma pluća, naročito u slučajeva kada nije izvodljiva invazivna dijagnostika kao i u praćenju efekata terapije i ranom otkrivanju relapsa bolesti. Rezultati velikih retrospektivnih ili prospektivnih studija ukazuju na izvesnu vrednost specifičnih markera ili kombinacija ovih markera za dijagnostičke i diferencijalno dijagnostičke svrhe. Merenje četiri serum tumor markera, CYFRA 21-1, CEA, NSE i ProGRP ima opravdanja da bi se identifikovao vodeći marker i na taj način predpostavio verovatni histološki tip tumora. Serijska određivanja odgovarajućeg tumor markera može takođe biti od pomoći da se utvrdi kompletnost uklanjanja tumora i utvrdi relaps bolesti u okultnom kliničkom stadijumu.
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Abstract
The expression of biomarkers by lung cancers is useful in the diagnosis and clinical management of patients with lung cancer. Biomarkers provide insight into histogenesis, interrelationships, and biological behavior of lung tumors. This chapter presents data on lung cancer detection, involving some of the most studied and interesting lung cancer biomarkers to date-CYFRA 21-1, NSE, ProGRP, SCC, CEA, Tumor M2-PK, as well as markers in clinical application such as CRP, LDH, tumor-suppressor genes and oncogenes, CA125, CgA, NCAM, and TPA. Biomarker profiles in combination with fuzzy logic techniques have also been addressed. Serum markers used alone or in combination with other indices might play an important role in monitoring response to therapy in early detection of tumor reactivation in new treatment strategies as well as in secondary prevention.
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Affiliation(s)
- Joachim Schneider
- Institut und Poliklinik für Arbeits- und Sozialmedizin der Justus-Liebig Universität, Aulweg 129/III, D-35385 Giessen, Germany
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Nisman B, Heching N, Biran H, Barak V, Peretz T. The prognostic significance of circulating neuroendocrine markers chromogranin a, pro-gastrin-releasing peptide and neuron-specific enolase in patients with advanced non-small-cell lung cancer. Tumour Biol 2005; 27:8-16. [PMID: 16340245 DOI: 10.1159/000090151] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2005] [Accepted: 06/17/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chromogranin A (CGA), Pro-gastrin-releasing peptide (ProGRP) and neuron-specific enolase (NSE) are known as immunohistochemical tissue markers closely associated with neuroendocrine differentiation in non-small-cell lung carcinoma (NSCLC). The aim of the present study was to assess the value of serum levels of these markers in predicting response to chemotherapy and survival of patients with unresectable NSCLC. METHODS The study included 67 patients with advanced NSCLC treated with chemotherapy. Before treatment, serum levels of CGA, ProGRP and NSE were measured with commercial kits. RESULTS No association was found between serum NSE and age, gender, histology, performance status or extent of the disease. Distribution of serum CGA differed significantly according to gender and histology, with higher levels being found in men (p = 0.01) and in squamous cell carcinoma (p = 0.01). Serum ProGRP levels correlated with disease extent, being higher in patients with metastatic disease (M1) than in those with locoregional disease (M0; p = 0.02). The association of NSE, CGA and ProGRP levels with response to chemotherapy was not significant. While NSE had no impact on survival, the median survival was shorter for patients with elevated serum CGA and longer for patients with high ProGRP levels. Association with survival was significant when the Classification and Regression Tree (CART)-derived or median cutoff points were explored. On inclusion in multivariate Cox models, both CGA and ProGRP retained significance with high levels showing an opposite effect on survival [CART-derived cutoff points: CGA, relative risk (RR) -4.0; p < 0.001, and ProGRP, RR -0.4; p = 0.006, and median cutoff points: CGA, RR -1.8; p = 0.04, and ProGRP, RR -0.5; p = 0.03]. The combined use of CGA, ProGRP and NSE allowed for definition of two sets of patients with significantly different median survival times (25.2 vs. 8.8 months, p = 0.0001). CONCLUSIONS In the circulation, CGA and Pro-GRP appear to bear important information related to the prognosis for NSCLC patients before chemotherapy. While a high CGA before treatment was found as an unfavorable prognostic determinant, a high ProGRP conferred a survival advantage. The combined use of serum CGA, ProGRP and NSE may supply additional information to prognosis.
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Affiliation(s)
- Benjamin Nisman
- Department of Oncology, Hadassah University Hospital, Jerusalem, Israel.
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Zhu AP, Zhang QY, Wang YM, Xu JJ, Sun L. Expression of human neuron-specific enolase gene in human hepatocellular cancer cells BEL7402. Shijie Huaren Xiaohua Zazhi 2005; 13:2193-2196. [DOI: 10.11569/wcjd.v13.i18.2193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the expression of neuron-specific enolase(NSE) in hepatocellular cancer cells BEL7402 at the levels of transcription, protein and cells.
METHODS: The fragment of NSE gene was amplified from human hepatocellular cancer cell strain BEL7402 by reverse transcription polymerase chain reaction (RT-PCR) with NSE specific primers. The NSE expression was detected in the BEL7402 cells by Western blot and immunocytochemical (ICC) staining.
RESULTS: NSE product with a length of 1 305 bp was obtained by by RT-PCR. Western blot confirmed that Mr 50 000 NSE protein was expressed in BEL7402 cells. Positive reaction of BEL7402 with anti-NSE monoclonal antibody was observed by immunocytochemistry. The expression of NSE existed in BEL7402 cells at the levels of transcription, protein and cells.
CONCLUSION: The NSE can be expressed and transcribed in hepatocellular carcinoma cells BEL7402.
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Abstract
Progastrin-releasing peptide (ProGRP) is a recently identified biomarker of small cell lung cancer (SCLC), a disorder of neuroendocrine tissue differentiation. The upper normal limit of ProGRP in the circulation is 50 pg/ml. Impaired glomerular filtration tends to increase circulating levels and confound the tumor marker significance of modestly elevated values. Excluding patients with renal failure, circulating levels did not exceed 80 pg/ml in benign disease (3% of cases in excess of the upper normal limit) or 120 pg/ml in malignancy other than lung cancer and neuroendocrine tumors (5% of cases in excess of the upper limit). ProGRP serum levels are clearly related to the lung cancer histological type with significantly higher levels observed in SCLC than in nonsmall cell lung cancer (NSCLC). Circulating ProGRP in excess of 120 mg/ml was found in only 4% of cases of NSCLC with another 22% presenting with modestly elevated levels in excess of the upper normal limit. By contrast, abnormal ProGRP results are found in 60-70% and in 75-90% of SCLC patients with local and extensive disease, respectively. ProGRP is a more sensitive biomarker than is neuron-specific enolase (NSE) for SCLC, but thus far has not been found in multivariate analysis to have independent prognostic significance. Preliminary studies suggest ProGRP will have utility in conjunction with NSE in monitoring the therapy of established SCLC.
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Affiliation(s)
- Rafael Molina
- Oncobiology Unit Laboratory of Clinical Biochemistry, IDIBAPS, Hospital Clinic, Barcelona 08036, Spain.
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Colice GL, Rubins J, Unger M. Follow-up and surveillance of the lung cancer patient following curative-intent therapy. Chest 2003; 123:272S-283S. [PMID: 12527585 DOI: 10.1378/chest.123.1_suppl.272s] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
The following two distinctly different issues should be taken into account when planning patient care following curative-intent therapy for lung cancer: adequate follow-up to manage complications related to the curative-intent therapy; and surveillance to detect recurrences of the primary lung cancer and/or development of a new primary lung cancer early enough to allow potentially curative retreatment. Follow-up for complications should be performed by the specialist responsible for the curative-intent therapy and should last 3 to 6 months. Recurrences of the original lung cancer will be more likely during the first 2 years after curative-intent therapy, but there will be an increased lifelong risk of approximately 1 to 2% per year of developing a metachronous, or new primary, lung cancer. A standard surveillance program for these patients is recommended based on periodic visits, with chest-imaging studies and counseling patients on symptom recognition. Whether subgroups of patients with a higher risk of developing a metachronous lung cancer (eg, those patients whose primary lung cancer was radiographically occult or central and those patients surviving for > 2 years after treatment for small cell lung cancer) should have a more intensive surveillance program is presently unclear. The surveillance program should be coordinated by a multidisciplinary tumor board and overseen by the physician who diagnosed and initiated therapy for the original lung cancer. Smoking cessation is recommended for all patients following curative-intent therapy for lung cancer.
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Affiliation(s)
- Gene L Colice
- Critical Care and Respiratory Services, Washington Hospital Center, 110 Irving Street NW, Washington, DC 20010, USA.
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Ide A, Ashizawa K, Ishikawa N, Ishii R, Ando T, Abe Y, Sera N, Usa T, Tominaga T, Ejima E, Nakashima M, Ito K, Ito K, Eguchi K. Elevation of serum pro-gastrin-releasing peptide in patients with medullary thyroid carcinoma and small cell lung carcinoma. Thyroid 2001; 11:1055-61. [PMID: 11762716 DOI: 10.1089/105072501753271752] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Medullary thyroid carcinoma (MTC) arises from parafollicular or C cells of the thyroid gland and produces a variety of peptides such as calcitonin (CT) and gastrin-releasing peptide (GRP). Here we measured serum levels of pro-gastrin-releasing peptide (Pro-GRP), a more stable precursor of GRP, in 15 patients with MTC (4 males, 11 females) who did not show any clinical or radiologic signs of small cell lung cancer. Serum Pro-GRP levels were elevated in 80% (12/15) patients. Significant correlation was observed between serum Pro-GRP and CT (r = 0.52) and carcinoembryonic antigen (CEA) (r = 0.56). Serum Pro-GRP levels also correlated with tumor size (r = 0.70). Serum Pro-GRP levels also decreased below the cut-off range in one patient after surgical resection. Our data suggest that Pro-GRP, which is considered to be a specific marker for small cell lung carcinoma, seems to be also helpful and additional marker for the diagnosis and monitoring the response to therapy in patients with MTC in addition to calcitonin as the main tumor marker.
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Affiliation(s)
- A Ide
- First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan
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