1
|
Xiong H, Zhang X, Sun J, Xue Y, Yu W, Mou S, Hsia KJ, Wan H, Wang P. Recent advances in biosensors detecting biomarkers from exhaled breath and saliva for respiratory disease diagnosis. Biosens Bioelectron 2025; 267:116820. [PMID: 39374569 DOI: 10.1016/j.bios.2024.116820] [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: 05/28/2024] [Revised: 09/06/2024] [Accepted: 09/28/2024] [Indexed: 10/09/2024]
Abstract
The global demand for rapid and non-invasive diagnostic methods for respiratory diseases has significantly intensified due to the wide spread of respiratory infectious diseases. Recent advancements in respiratory disease diagnosis through the analysis of exhaled breath and saliva has attracted great attention all over the world. Among various analytical methods, biosensors can offer non-invasive, efficient, and cost-effective diagnostic capabilities, emerging as promising tools in this area. This review intends to provide a comprehensive overview of various biosensors for the detection of respiratory disease related biomarkers in exhaled breath and saliva. Firstly, the characteristics of exhaled breath and saliva, including their generation, composition, and relevant biomarkers are introduced. Subsequently, the design and application of various biosensors for detecting these biomarkers are presented, along with the innovative materials employed as sensitive components. Different types of biosensors are reviewed, including electrochemical, optical, piezoelectric, semiconductor, and other novel biosensors. At last, the challenges, limitations, and future trends of these biosensors are discussed. It is anticipated that biosensors will play a significant role in respiratory disease diagnosis in the future.
Collapse
Affiliation(s)
- Hangming Xiong
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China; Binjiang Institute of Zhejiang University, Hangzhou 310053, China
| | - Xiaojing Zhang
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China; Cancer Center, Zhejiang University, Hangzhou 310058, China
| | - Jiaying Sun
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China
| | - Yingying Xue
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China; Cancer Center, Zhejiang University, Hangzhou 310058, China
| | - Weijie Yu
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China; Binjiang Institute of Zhejiang University, Hangzhou 310053, China
| | - Shimeng Mou
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China; Cancer Center, Zhejiang University, Hangzhou 310058, China
| | - K Jimmy Hsia
- Schools of Chemical & Biomedical Engineering, Nanyang Technological University, Singapore 639798, Singapore
| | - Hao Wan
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China; Binjiang Institute of Zhejiang University, Hangzhou 310053, China.
| | - Ping Wang
- Biosensor National Special Laboratory, Key Laboratory of Biomedical Engineering of Education Ministry, Department of Biomedical Engineering, Zhejiang University, Hangzhou 310027, China; Cancer Center, Zhejiang University, Hangzhou 310058, China.
| |
Collapse
|
2
|
Skirda AM, Orlov AV, Malkerov JA, Znoyko SL, Rakitina AS, Nikitin PI. Enhanced Analytical Performance in CYFRA 21-1 Detection Using Lateral Flow Assay with Magnetic Bioconjugates: Integration and Comparison of Magnetic and Optical Registration. BIOSENSORS 2024; 14:607. [PMID: 39727872 DOI: 10.3390/bios14120607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Revised: 11/28/2024] [Accepted: 12/06/2024] [Indexed: 12/28/2024]
Abstract
A novel approach to developing lateral flow assays (LFAs) for the detection of CYFRA 21-1 (cytokeratin 19 fragment, a molecular biomarker for epithelial-origin cancers) is proposed. Magnetic bioconjugates (MBCs) were employed in combination with advanced optical and magnetic tools to optimize assay conditions. The approach integrates such techniques as label-free spectral-phase interferometry, colorimetric detection, and ultrasensitive magnetometry using the magnetic particle quantification (MPQ) technique. For the first time in LFA applications, the MPQ-based and colorimetry-based detection methods were compared side by side, and superior analytical performance was demonstrated. The limit of detection (LOD) of 0.9 pg/mL was achieved using MPQ, and 2.9 pg/mL with optical detection. This study has demonstrated that MPQ provides elimination of signal saturation, higher sensitivity (slope of the calibration curve), and a 19-fold wider dynamic range of detected signals. Both optical and magnetic detection results are comparable to the best laboratory-based tests with the added benefits of a 20-min assay duration and the LFA format convenience. The assay effectiveness was validated in human serum and artificial saliva, and high recovery rates were observed. The proposed approach offers rapid and reliable detection of molecular biomarkers and holds significant potential for point-of-care diagnostics, particularly in resource-limited settings.
Collapse
Affiliation(s)
- Artemiy M Skirda
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov Street, 119991 Moscow, Russia
- Moscow Center for Advanced Studies, Kulakova Str. 20, 123592 Moscow, Russia
| | - Alexey V Orlov
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov Street, 119991 Moscow, Russia
| | - Juri A Malkerov
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov Street, 119991 Moscow, Russia
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), 31 Kashirskoe Shosse, 115409 Moscow, Russia
| | - Sergey L Znoyko
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov Street, 119991 Moscow, Russia
| | - Alexandra S Rakitina
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov Street, 119991 Moscow, Russia
- Moscow Center for Advanced Studies, Kulakova Str. 20, 123592 Moscow, Russia
| | - Petr I Nikitin
- Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov Street, 119991 Moscow, Russia
- National Research Nuclear University MEPhI (Moscow Engineering Physics Institute), 31 Kashirskoe Shosse, 115409 Moscow, Russia
| |
Collapse
|
3
|
Wang M, Shu J, Zhang R, Yang D, Teng G, Cui H. Chemiluminescent Fe 3O 4@Nickel-Cobalt Double Hydroxide Magnetic Core-Shell Nanomaterial as an Analytical Interface for Label-Free CYFRA21-1 Immunosensing. Anal Chem 2024; 96:18890-18897. [PMID: 39536324 DOI: 10.1021/acs.analchem.4c05038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
Cytokeratin 19 fragment (CYFRA21-1) is considered to be a potential marker for the diagnosis and of classification of lung cancer. It is highly desired to develop rapid and highly sensitive label-free chemiluminescence (CL) immunosensors for the detection of CYFRA21-1. In this work, magnetic core-shell nanocomposite Fe3O4@nickel-cobalt double hydroxide (Fe3O4@DH) was used for the first time as a carrier to synthesize N-(4-aminobutyl)-N-ethylisoluminol (ABEI) and gold and silver nanocluster (AuAgNC) bifunctionalized magnetic nanomaterials Fe3O4@DH/AuAgNCs-ABEI. The resulting Fe3O4@DH/AuAgNCs-ABEI demonstrated excellent CL performance, attributed to the exceptional catalytic capability of nickel-cobalt double hydroxide (NiCo-DH) and AuAgNCs, as well as the large specific surface area of NiCo-DH for AuAgNCs and ABEI enrichment. Moreover, Fe3O4@DH/AuAgNCs-ABEI exhibited superior stability compared to Fe3O4-based CL-functionalized magnetic nanomaterials, owing to the presence of NiCo-DH shells. On this basis, a label-free CL immunosensor using CYFRA21-1 antibody-modified Fe3O4@DH/AuAgNCs-ABEI as an analytical interface was constructed for the detection of CYFRA21-1 in the range from 1.0 × 10-13 to 1.0 × 10-8 g/mL. The detection limit of this CL immunosensor was 47.7 fg/mL, 4 orders of magnitude lower than existing CL methods. The CL immunosensor was able to accurately detect the concentration of CYFRA21-1 in serum samples, as evidenced by ELISA results. More importantly, it not only distinguished well between healthy persons and lung cancer patients (90.0% sensitivity and 90.0% specificity), but also effectively distinguished between patients with non-small cell lung cancer and small cell lung cancer (80.0% sensitivity and 86.7% specificity).
Collapse
Affiliation(s)
- Manli Wang
- Key Laboratory of Precision and Intelligent Chemistry, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Jiangnan Shu
- Key Laboratory of Precision and Intelligent Chemistry, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Ruoxian Zhang
- Key Laboratory of Precision and Intelligent Chemistry, University of Science and Technology of China, Hefei, Anhui 230026, China
| | - Dongliang Yang
- The Second Department of Thoracic Surgery, Anhui Chest Hospital, Hefei, Anhui 230022, China
| | - Gang Teng
- Department of Respiratory Medicine, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui 230031, China
| | - Hua Cui
- Key Laboratory of Precision and Intelligent Chemistry, University of Science and Technology of China, Hefei, Anhui 230026, China
| |
Collapse
|
4
|
Taher MY, Hassouna EM, El-Hadidi AS, El-Aassar OS, Bakosh MF. Predictive Value of Serum CYFRA 21-1 and CK19-2G2 for Tumor Aggressiveness and Overall Survival in Hepatitis C-Related Hepatocellular Carcinoma Among Egyptians: A Prospective Study. J Gastrointest Cancer 2024; 55:749-758. [PMID: 38231289 DOI: 10.1007/s12029-023-01012-4] [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] [Accepted: 12/31/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE Cytokeratin 19 fragment 21-1 (CYFRA 21-1) and cytokeratin 19 fragment 2G2 (CK 19-2G2) are two soluble fragments of cytokeratin 19 (CK 19) that can be detected in serum. CK 19-positive hepatocellular carcinoma (HCC) is characterized by an aggressive behavior and a poor outcome. This study aimed to assess the prognostic value of serum CYFRA 21-1 and CK 19-2G2 in predicting tumor aggressiveness and overall survival (OS) in patients with hepatic C virus (HCV)-related HCC. METHODS The current study included 138 patients with HCV-related HCC recruited from the Hepatobiliary and Interventional Radiology Units at Alexandria's main university hospitals and 40 healthy individuals as controls. Patients were assessed for clinical, radiological tumor characteristics, and aggressiveness index. Baseline serum CYFRA 21-1 and CK 19-2G2 levels were measured by enzyme-linked immunosorbent assay. RESULTS Elevated CYFRA 21-1 levels were associated with tumors size ≥ 5 cm (p < 0.001), malignant portal vein thrombosis (mPVT) (p < 0.001), distant metastasis (p = 0.030), ill-defined/infiltrative pattern (p = 0.010), and aggressiveness index > 4 (p = 0.045). Elevated CK19-2G2 levels were not associated with any clinical or radiological characteristics. Either or both elevated serum CYFRA 21-1 and CK 19-2G2 in combination with alpha-feto protein (AFP) ≥ 400 ng/ml have a better predictability for mPVT and ill-defined/infiltrative patterns (sensitivity (10-25%) and specificity (96-100%)). Elevated levels of CYFRA 21-1, CK 19-2G2, or AFP ≥ 400 ng/ml were associated with decreased 1-year OS. CONCLUSIONS Either or both elevated serum CYFRA 21-1 and CK 19-2G2 levels when added to AFP ≥ 400 ng/ml are specific but less sensitive biomarkers for predicting tumor aggressiveness. These biomarkers can be used independently to predict reduced 1-year OS in Egyptian patients with HCV-related HCC.
Collapse
Affiliation(s)
- Mohamed Yousry Taher
- Hepatobiliary Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ehab Mostafa Hassouna
- Hepatobiliary Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Abeer Shawky El-Hadidi
- Clinical and Chemical Pathology Department, Faculty of Medicine, Alexandria University, Egypt
| | - Omar Sameh El-Aassar
- Diagnostic and Interventional Radiology Department, Faculty of Medicine, Alexandria University, Egypt
| | - Mohamed Fathy Bakosh
- Hepatobiliary Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
| |
Collapse
|
5
|
Tang B, Hu X, Xu D, Zhang G, Zhang H, Guo C, Liu S, Gao Q, Li Y, Tang M. Value of serum tumor markers in early differential diagnosis of spinal tumors and spinal infections. ZHONG NAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF CENTRAL SOUTH UNIVERSITY. MEDICAL SCIENCES 2024; 49:1421-1430. [PMID: 39931772 DOI: 10.11817/j.issn.1672-7347.2024.230603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2025]
Abstract
OBJECTIVES The early imaging features of spinal tumors and spinal infections are similar, and the lack of specific early diagnostic indicators can lead to misdiagnosis or missed diagnosis. Although serum tumor markers have been widely used in early cancer screening, spinal tumors are mostly metastatic, lacking specific markers, and some patients with spinal tumors may even test negative for tumor markers. Therefore, the role of tumor markers in the early differential diagnosis of spinal tumors remains unclear. This study aims to investigate the value of tumor markers in the early differential diagnosis of spinal tumors and spinal infection. METHODS We retrospectively analyzed the clinical data of 221 patients with spinal bone destruction admitted to Xiangya Hospital of Central South University between April 2017 and October 2022. Peripheral blood levels of 10 tumor markers were measured upon admission, including carcinoembryonic antigen (CEA), alpha fetoprotein (AFP), neuron-specific enolase (NSE), cytokeratin 19 fragment antigen 21-1 (cyfra21-1), carbohydrate antigen 199 (CA199), carbohydrate antigen 125 (CA125), carbohydrate antigen 72-4 (CA72-4), pepsinogen I (PGI), pepsinogen II (PGII), and the PGI/PGII ratio (PGR). Univariate Logistic analysis was used to screen relevant variables, and the correlation between tumor markers was analyzed. Multivariate Logistic regression was then employed to identify risk and protective factors. The optimal cut-off values were calculated using the receiver operating characteristic (ROC) curve and Youden index, and a differential diagnosis model for early spinal tumors and spinal infections was constructed based on the selected indicators. Diagnostic performance was then evaluated. RESULTS According to the pathological diagnosis, 91 patients had spinal tumors, and 130 patients had spinal infections. The levels of CEA, AFP, NSE, cyfra21-1, CA199, and CA72-4 were higher in the spinal tumor group than those in the spinal infection group, while PGR was lower, with statistically significant differences (all P<0.05). Univariate Logistic analysis showed significant differences in CEA, AFP, NSE, cyfra21-1, CA199, CA125, CA72-4, and PGR (all P<0.05). Correlation analysis indicated a strong positive correlation between CEA and cyfra21-1, CA199, and CA125, as well as a strong negative correlation of PGII with PGI and PGR. Multivariate Logistic analysis identified AFP and cyfra21-1 as risk factors (P<0.01) and PGR as a protective factor (P<0.05). When the standard cut-off values (AFP<20 ng/mL, cyfra21-1< 3.3 ng/mL, and PGR>3) were applied, AFP had a sensitivity of 3.3% and accuracy of 60.2%, cyfra21-1 had a sensitivity of 20.9% and accuracy of 66.1%, and PGR had a sensitivity of 2.2% and accuracy of 59.3%. The AUC of the early spinal tumor diagnosis model was 0.623. Using the optimal cut-off values (AFP<1.625 ng/mL, cyfra21-1<1.175 ng/mL, and PGR>11.05) from the ROC curve, AFP had a sensitivity of 69.2% and accuracy of 64.7%, cyfra21-1 had a sensitivity of 68.1% and accuracy of 70.1%, and PGR had a sensitivity of 62.6% and accuracy of 57.5%, with the model's AUC at 0.772. CONCLUSIONS A comparative analysis of 10 serum tumor markers reveals that AFP, cyfra21-1, and PGR are significantly associated with spinal tumors. The diagnostic model constructed based on these 3 markers shows promising predictive performance and may be helpful to the differentiation for the early clinical diagnosis of spinal tumors and spinal infection.
Collapse
Affiliation(s)
- Bo Tang
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008.
| | - Xiaojiang Hu
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008
| | - Dongcheng Xu
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008
| | - Guang Zhang
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008
| | - Hongqi Zhang
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008
| | - Chaofeng Guo
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008
| | - Shaohua Liu
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008
| | - Qile Gao
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008
| | - Yanbing Li
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Mingxing Tang
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha 410008.
| |
Collapse
|
6
|
Trulson I, Holdenrieder S. Prognostic value of blood-based protein biomarkers in non-small cell lung cancer: A critical review and 2008-2022 update. Tumour Biol 2024; 46:S111-S161. [PMID: 37927288 DOI: 10.3233/tub-230009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Therapeutic possibilities for non-small cell lung cancer (NSCLC) have considerably increased during recent decades. OBJECTIVE To summarize the prognostic relevance of serum tumor markers (STM) for early and late-stage NSCLC patients treated with classical chemotherapies, novel targeted and immune therapies. METHODS A PubMed database search was conducted for prognostic studies on carcinoembryonic antigen (CEA), cytokeratin-19 fragment (CYFRA 21-1), neuron-specific enolase, squamous-cell carcinoma antigen, progastrin-releasing-peptide, CA125, CA 19-9 and CA 15-3 STMs in NSCLC patients published from 2008 until June 2022. RESULTS Out of 1069 studies, 141 were identified as meeting the inclusion criteria. A considerable heterogeneity regarding design, patient number, analytical and statistical methods was observed. High pretherapeutic CYFRA 21-1 levels and insufficient decreases indicated unfavorable prognosis in many studies on NSCLC patients treated with chemo-, targeted and immunotherapies or their combinations in early and advanced stages. Similar results were seen for CEA in chemotherapy, however, high pretherapeutic levels were sometimes favorable in targeted therapies. CA125 is a promising prognostic marker in patients treated with immunotherapies. Combinations of STMs further increased the prognostic value over single markers. CONCLUSION Protein STMs, especially CYFRA 21-1, have prognostic potential in early and advanced stage NSCLC. For future STM investigations, better adherence to comparable study designs, analytical methods, outcome measures and statistical evaluation standards is recommended.
Collapse
Affiliation(s)
- Inga Trulson
- Munich Biomarker Research Center, Institute for Laboratory Medicine, German Heart Center, Technical University of Munich, Munich, Germany
| | - Stefan Holdenrieder
- Munich Biomarker Research Center, Institute for Laboratory Medicine, German Heart Center, Technical University of Munich, Munich, Germany
| |
Collapse
|
7
|
Minamibata A, Kono Y, Arimoto T, Marunaka Y, Takayama K. Variability of serum CYFRA 21 - 1 and its susceptibility to clinical characteristics in individuals without cancer: a 4-year retrospective analysis. BMC Pulm Med 2023; 23:344. [PMID: 37705035 PMCID: PMC10500899 DOI: 10.1186/s12890-023-02650-x] [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: 05/26/2023] [Accepted: 09/11/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND CYFRA 21 - 1 is a useful marker for diagnosing and monitoring lung cancer. However, its stability remains unclear. Moreover, while its applicability to screening is now being investigated, CYFRA 21 - 1 levels in individuals without cancer, who are targets for cancer screening, have not yet been the focus of research. Therefore, the present study investigated variability in and the factors increasing serum CYFRA 21 - 1 levels. METHODS This retrospective study recruited 951 individuals undergoing annual medical examinations for six years. We used data obtained in the first four years. Variability in serum CYFRA 21 - 1 levels over a period of four years were investigated. CYFRA 21 - 1 was categorized as normal (≤ 3.5 ng/ml) or elevated (> 3.5 ng/ml). The rate of an elevated level in one visit and the transition from an elevated to normal level between visits were visualized. A multiple logistic regression model was used to study the relationships between the frequency of elevated CYFRA 21 - 1 levels and clinical characteristics, such as age, sex, body mass index, weight changes, and the smoking status. RESULTS Approximately 5% of subjects had elevated CYFRA 21 - 1 levels once in five tests over four years, while 15% had elevated CYFRA 21 - 1 levels once or more. Among subjects with elevated CYFRA 21 - 1 levels in one blood test, between 63 and 72% had normal levels in the next test. The median CYFRA 21 - 1 level in subjects with elevations in one blood test significantly decreased in the next test at all four time points. The frequency of elevated CYFRA 21 - 1 levels was associated with an older age [odds ratio (OR) = 6.99, 95% confidence interval (CI) = 3.01-16.2], current heavy smoking (OR = 3.46, 95% CI = 1.52-7.9), and weight loss (OR = 1.86, 95% CI = 1.07-3.24). CONCLUSIONS Variability in and the factors increasing serum CYFRA 21 - 1 levels beyond the cut-off value need to be considered when interpretating CYFRA 21 - 1 test results. The future application of CYFRA 21 - 1 to lung cancer screening may require more than a single measurement.
Collapse
Affiliation(s)
- Asami Minamibata
- Medical Research Institute, Kyoto Industrial Health Association, 67 Kita-Tsuboicho Nishinokyo Nakagyo-ku, Kyoto, 604-8472, Japan.
| | - Yoshihito Kono
- Medical Research Institute, Kyoto Industrial Health Association, 67 Kita-Tsuboicho Nishinokyo Nakagyo-ku, Kyoto, 604-8472, Japan
| | - Taichiro Arimoto
- Medical Research Institute, Kyoto Industrial Health Association, 67 Kita-Tsuboicho Nishinokyo Nakagyo-ku, Kyoto, 604-8472, Japan
| | - Yoshinori Marunaka
- Medical Research Institute, Kyoto Industrial Health Association, 67 Kita-Tsuboicho Nishinokyo Nakagyo-ku, Kyoto, 604-8472, Japan
| | - Koichi Takayama
- Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
8
|
Jiang M, Chen P, Zhang X, Guo X, Gao Q, Ma L, Mei W, Zhang J, Zheng J. Metabolic phenotypes, serum tumor markers, and histopathological subtypes in predicting bone metastasis: analysis of 695 patients with lung cancer in China. Quant Imaging Med Surg 2023; 13:1642-1654. [PMID: 36915307 PMCID: PMC10006154 DOI: 10.21037/qims-22-741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/09/2022] [Indexed: 02/04/2023]
Abstract
Background Patients with lung cancer who develop bone metastasis (BM) generally have an adverse prognosis. Although several clinical models have been used to predict BM in patients with lung cancer, the results are unsatisfactory. In this retrospective study, we investigated the role of 18F-2-fluoro-2-deoxyglucose (FDG) metabolic activity, serum tumor markers, and histopathological subtypes in predicting BM in patients with lung cancer. Methods This study included 695 consecutive patients with lung cancer who underwent 18F-FDG positron emission tomography/computed tomography (PET/CT) and in whom serum tumor markers were detected prior to treatment. The maximum standardized uptake value of primary tumors (pSUVmax), metastatic lymph nodes (nSUVmax) and distant metastases (mSUVmax), 8 serum tumor markers [carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), squamous cell carcinoma-related antigen (SCCA), cytokeratin 19 fragment (CYFRA21-1), carbohydrate antigen (CA) 125, CA50, CA72-4, and ferritin], and histopathological subtypes were compared between patients with and without BM. Receiver operating characteristic (ROC) curve and multiple logistic regression analyses were performed to identify predictors of BM in patients with lung cancer. Results BM was identified in 133 (19.1%) patients and not in 562 (80.9%). Patients with BM had significantly higher pSUVmax, nSUVmax, and mSUVmax than did those without BM. High concentrations of 6 serum tumor markers (i.e., CEA, ferritin, NSE, CA50, CA125, and CYFRA21-1) were significantly associated with BM. There were significant differences in the proportion of histopathological subtypes between patients with and without BM (χ2=32.35; P<0.001). The area under ROC-derived curve based on metabolic parameters was 0.737 (95% CI: 0.644-0.829) and 0.884 (95% CI: 0.825-0.943) when combined with the 6 serum tumor markers and histopathological subtypes, respectively. Conclusions High pSUVmax, nSUVmax, and mSUVmax favor the presence of BM in patients with lung cancer, and serum tumor markers and histopathological subtypes are important factors for predicting BM in these patients.
Collapse
Affiliation(s)
- Maoqing Jiang
- Department of Radiology and PET/CT Center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Department of Nuclear Medicine, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Ping Chen
- Department of Nephrology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Xiaohui Zhang
- Department of Radiology and PET/CT Center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Xiuyu Guo
- Department of Radiology and PET/CT Center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Qiaoling Gao
- Department of Radiology and PET/CT Center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Lijuan Ma
- Department of Radiology and PET/CT Center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Weiqi Mei
- Department of Nuclear Medicine, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Jingfeng Zhang
- Department of Radiology and PET/CT Center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Jianjun Zheng
- Department of Radiology and PET/CT Center, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| |
Collapse
|
9
|
Huang H, Yang Y, Zhu Y, Chen H, Yang Y, Zhang L, Li W. Blood protein biomarkers in lung cancer. Cancer Lett 2022; 551:215886. [PMID: 35995139 DOI: 10.1016/j.canlet.2022.215886] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 11/17/2022]
Abstract
Lung cancer has consistently ranked first as the cause of cancer-associated mortality. The 5-year survival rate has risen slowly, and the main obstacle to improving the prognosis of patients has been that lung cancer is usually diagnosed at an advanced or incurable stage. Thus, early detection and timely intervention are the most effective ways to reduce lung cancer mortality. Tumor-specific molecules and cellular elements are abundant in circulation, providing real-time information in a noninvasive and cost-effective manner during lung cancer development. These circulating biomarkers are emerging as promising tools for early detection of lung cancer and can be used to supplement computed tomography screening, as well as for prognosis prediction and treatment response monitoring. Serum and plasma are the main sources of circulating biomarkers, and protein biomarkers have been most extensively studied. In this review, we summarize the research progress on three most common types of blood protein biomarkers (tumor-associated antigens, autoantibodies, and exosomal proteins) in lung cancer. This review will potentially guide researchers toward a more comprehensive understanding of candidate lung cancer protein biomarkers in the blood to facilitate their translation to the clinic.
Collapse
Affiliation(s)
- Hong Huang
- Institute of Clinical Pathology, Key Laboratory of Transplantation Engineering and Immunology, Ministry of Health, West China Hospital, Sichuan University, Chengdu, 610041, China; Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Yongfeng Yang
- Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China; Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Yihan Zhu
- Institute of Clinical Pathology, Key Laboratory of Transplantation Engineering and Immunology, Ministry of Health, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Hongyu Chen
- Institute of Clinical Pathology, Key Laboratory of Transplantation Engineering and Immunology, Ministry of Health, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Ying Yang
- Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Li Zhang
- Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China; Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Weimin Li
- Institute of Respiratory Health, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China; Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, 610041, China; Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China; The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Chengdu, 610041, China.
| |
Collapse
|
10
|
Filik H, Avan AA, Altaş Puntar N, Özyürek M, Çakıcı M, Güngör ZB, Kucur M, Kamış H. Electrochemical immunosensor for individual and simultaneous determination of Cytokeratin fragment antigen 21-1 and Neuron-specific enolase using carbon dots-decorated multiwalled carbon nanotube electrode. Microchem J 2022. [DOI: 10.1016/j.microc.2022.107990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
11
|
Li J, Lin X, Li X, Zhang W, Sun D. Somatic mutations combined with clinical features can predict the postoperative prognosis of stage IIIA lung adenocarcinoma. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:187. [PMID: 35280419 PMCID: PMC8908182 DOI: 10.21037/atm-22-130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/27/2022] [Indexed: 11/29/2022]
Abstract
Background Prognostic factors for stage IIIA lung adenocarcinoma (LUAD) are unclear. The current main treatment for stage IIIA LUAD is still controversial. Some Clinicians advocate synchronous chemoradiotherapy as the main treatment for stage IIIA LUAD. In contrast, some clinicians argue that there are still certain patients with stage IIIA LUAD who have a better postoperative prognosis. This study aimed to analyze preoperative factors as well as the association between somatic mutations and prognosis in stage IIIA LUAD [including overall survival (OS) time and the risk of postoperative recurrence]. Methods This study retrospectively reviewed the data of patients with stage IIIA LUAD who underwent radical resection of lung cancer in the thoracic surgery department of Tianjin Chest Hospital from January 01, 2011 to September 30, 2016. All patients involved in the study provided written informed consent. The associations between OS and DFS and the clinical characteristics as well as somatic mutations of patients were analyzed separately. The Kaplan-Meier method was used for univariate analysis, and survival curves were drawn. Multivariate analysis was performed by the Cox regression model. Results For univariate analysis, the prognostic factors of OS were the level of preoperative CYFRA21-1, the number of metastatic lymph node stations (NMLS), maximum tumor diameter, EGFR (epidermal growth factor receptor) classical base mutations, and the number of copies of POLE (polymerase epsilon) mutation (NCPM). Preoperative total protein level, preoperative CYFRA21-1 level, the number of metastatic lymph nodes (NMLN), maximum tumor diameter, the number of mutated genes (NMG) in tumor samples, TP53 mutations, and the number of copies of POLE mutation (NCPM) were associated with disease-free survival (DFS). The multivariate analysis showed that the preoperative CYFRA21-1 level, the number of metastatic lymph node stations (NMLS), and EGFR typical base mutations were independent prognostic factors of OS. The number of mutated genes (NMG), EGFR classical base mutations, preoperative NSE level, maximum tumor diameter, and the number of metastatic lymph node stations (NMLS) were independent prognostic factors for DFS. Conclusions The preoperative level of tumor markers, the number of metastatic lymph node stations, and EGFR typical base mutations are important factors for the prognosis of patients with resectable stage IIIA LUAD.
Collapse
Affiliation(s)
- Jiuzhen Li
- Graduate School, Tianjin Medical University, Tianjin, China.,Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, China
| | | | - Xin Li
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, China
| | - Weiran Zhang
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, China
| | - Daqiang Sun
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, China
| |
Collapse
|
12
|
Hu K, Cheng J, Wang K, Zhao Y, Liu Y, Yang H, Zhang Z. Sensitive electrochemical immunosensor for CYFRA21-1 detection based on AuNPs@MoS 2@Ti 3C 2T x composites. Talanta 2022; 238:122987. [PMID: 34857321 DOI: 10.1016/j.talanta.2021.122987] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/10/2021] [Accepted: 10/19/2021] [Indexed: 01/23/2023]
Abstract
Cytokeratin fragment antigen 21-1 (CYFRA21-1) is a sensitive marker for detecting non-small cell lung cancer (NSCLC). Ti3C2Tx modified by gold nanoparticles (AuNPs) and molybdenum disulfide (MoS2) were synthesized for the first time to obtain the AuNPs@MoS2@Ti3C2Tx composites, which have large specific surface area and good electrocatalytic properties. A novel electrochemical immunoassay for sensitive detection of CYFRA21-1 was developed by loading a large quantity of secondary antibodies (Ab2) and toluidine blue (TB) on the surface of the material as signal probe, and Nafion-AuNPs mixture as electrode material. When the electrochemical response value of CYFRA21-1 increased linearly within the concentration range of 0.5 pg mL-1-50 ng mL-1, the detection limit can reach as low as 0.03 pg mL-1. In addition, the experimental results showed that the biosensor had the potential to rapidly detect CYFRA21-1 in the complex samples such as patient serum, and had a broad application prospect in the early diagnosis and monitoring of NSCLC.
Collapse
Affiliation(s)
- Kai Hu
- Henan University of Chinese Medicine, Zhengzhou, 450046, PR China.
| | - Jiamin Cheng
- Henan University of Chinese Medicine, Zhengzhou, 450046, PR China
| | - Kangbin Wang
- Henan Research Institute of Breeding Livestock and Poultry Industry Co., Ltd, Zhengzhou, 450000, PR China
| | - Yuanqing Zhao
- Henan University of Chinese Medicine, Zhengzhou, 450046, PR China
| | - Yanju Liu
- Henan University of Chinese Medicine, Zhengzhou, 450046, PR China
| | - Huaixia Yang
- Henan University of Chinese Medicine, Zhengzhou, 450046, PR China.
| | - Zhenqiang Zhang
- Henan University of Chinese Medicine, Zhengzhou, 450046, PR China.
| |
Collapse
|
13
|
Yang L, Ma P, Chen X, Cheng Z, Lin J. High-Sensitivity Fluorescence Detection for lung cancer CYFRA21-1 DNA based on Accumulative Hybridization of Quantum Dots. J Mater Chem B 2022; 10:1386-1392. [DOI: 10.1039/d1tb02557k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Sensitive detection of circulating tumor DNA (ctDNA) in vitro has attracted growing attention owing to its potential application in diagnostics of cancer. In this study, we synthesized hydrophilic AgInS2@ZnS core-shell...
Collapse
|
14
|
Panahabadi S, Heindel K, Mueller A, Holdenrieder S, Kipfmueller F. Increased circulating cytokeratin 19 fragment levels in preterm neonates receiving mechanical ventilation are associated with poor outcome. Am J Physiol Lung Cell Mol Physiol 2021; 321:L1036-L1043. [PMID: 34585605 DOI: 10.1152/ajplung.00176.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Invasive mechanical ventilation and oxygen toxicity are postnatal contributors to chronic lung disease of prematurity, also known as bronchopulmonary dysplasia (BPD). Cyfra 21-1 is a soluble fragment of cytokeratin 19, which belongs to the cytoskeleton stabilizing epithelial intermediate filaments. As a biomarker of structural integrity, Cyfra 21-1 might be associated with airway injury and lung hypoplasia in neonates. Serum Cyfra 21-1 concentrations for 80 preterm and 80 healthy term newborns were measured within 48 h after birth. Preterm infants with the combined endpoint BPD/mortality had significantly higher Cyfra 21-1 levels compared with those without fulfilling BPD/mortality criteria (P = 0.01). Also, severe RDS (>grade III) was associated with higher Cyfra levels (P = 0.01). Total duration of oxygen therapy was more than five times longer in neonates with high Cyfra 21-1 levels (P = 0.01). Infants with higher Cyfra 21-1 values were more likely to receive mechanical ventilation (50% vs. 17.5%). However, the duration of mechanical ventilation was similar between groups. The median Cyfra value was 1.93 ng/mL (IQR: 1.68-2.53 ng/mL) in healthy term neonates and 8.5 ng/mL (IQR: 3.6-16.0 ng/mL) in preterm infants. Using ROC analysis, we calculated a Cyfra cutoff > 8.5 ng/mL to predict BPD/death with an AUC of 0.795 (P = 0.004), a sensitivity of 88.9%, and a specificity of 55%. Mortality was predicted with a cutoff > 17.4 ng/mL (AUC: 0.94; P = 0.001), a sensitivity of 100%, and a specificity of 84%. These findings suggest that Cyfra 21-1 concentration might be useful to predict poor outcome in premature infants.
Collapse
Affiliation(s)
- Sarah Panahabadi
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany.,Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
| | - Katrin Heindel
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany
| | - Andreas Mueller
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany
| | - Stefan Holdenrieder
- Institute for Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany.,Institute for Laboratory Medicine, German Heart Center of the State of Bavaria and the Technical University Munich, Munich, Germany
| | - Florian Kipfmueller
- Department of Neonatology and Pediatric Intensive Care, Children's Hospital, University of Bonn, Bonn, Germany
| |
Collapse
|
15
|
Zhang JH, Shen Q, Zhou YG. Quantification of Tumor Protein Biomarkers from Lung Patient Serum Using Nanoimpact Electrochemistry. ACS Sens 2021; 6:2320-2329. [PMID: 34033456 DOI: 10.1021/acssensors.1c00361] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Protein quantification with high throughput and high sensitivity is essential in the early diagnosis and elucidation of molecular mechanisms for many diseases. Conventional approaches for protein assay often suffer from high costs, long analysis time, and insufficient sensitivity. The recently emerged nanoimpact electrochemistry (NIE), as a contrast, allows in situ detection of analytes one at a time with simplicity, fast response, high throughput, and the potential of reducing the detection limits down to the single entity level. Herein, we propose a NIE-enabled electrochemical immunoassay using silver nanoparticles (AgNPs) as labels for the detection of CYFRA21-1, a typical protein marker for lung carcinoma. This strategy is based on the measurement of the impact frequency and the charge intensity of the electrochemical oxidation of individual AgNPs before and after they are modified with anti-CYFRA21-1 and in turn immunocomplexed with CYFRA21-1. Both the frequency and intensity modes of single-nanoparticle electrochemistry correlate well with each other, resulting in a self-validated immunoassay that provides linear ranges of two orders of magnitude and a limit of detection of 0.1 ng/mL for CYFRA21-1 analysis. The proposed immunoassay also exhibits excellent specificity when challenged with other possible interfering proteins. In addition, the CYFRA21-1 content is validated by a conventional, well-known enzyme-linked immunosorbent assay and successfully quantified in a diluted healthy serum with a satisfactory recovery. Moreover, CYFRA21-1 detection in serum samples of lung cancer patients is successfully demonstrated, suggesting the feasibility of the NIE-based immunoassay in clinically relevant diagnosis. To the best of our knowledge, this is the first report to construct NIE-based electrochemical immunoassays for the specific detection of tumor protein biomarkers.
Collapse
Affiliation(s)
- Jian-Hua Zhang
- Institute of Chemical Biology and Nanomedicine (ICBN), State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, P. R. China
| | - Qian Shen
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, P. R. China
| | - Yi-Ge Zhou
- Institute of Chemical Biology and Nanomedicine (ICBN), State Key Laboratory of Chemo/Biosensing and Chemometrics, College of Chemistry and Chemical Engineering, Hunan University, Changsha 410082, P. R. China
| |
Collapse
|
16
|
Wang Y, Li Y, Zhuang X, Tian C, Fu X, Luan F. Ru(bpy) 32+ encapsulated cyclodextrin based metal organic framework with improved biocompatibility for sensitive electrochemiluminescence detection of CYFRA21-1 in cell. Biosens Bioelectron 2021; 190:113371. [PMID: 34098359 DOI: 10.1016/j.bios.2021.113371] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/16/2021] [Accepted: 05/19/2021] [Indexed: 12/24/2022]
Abstract
Metal-organic frameworks (MOFs) have attracted strong interest from researchers. Here, for the first time, we report a sandwich-type electrochemiluminescent biosensor as a signal probe prepared from cyclodextrin-based MOF (CD-MOF)-encapsulated Ru(bpy)32+. Due to the combination of the two materials, the obtained CD-MOF@Ru(bpy)32+ nanocomposites exhibited excellent biocompatibility and electrochemical performance. At the same time, CD-MOF@Ru(bpy)32+ adhered to the electrode surface closely because Ru(bpy)32+ was successfully encapsulated by the CD-MOF. In this paper, CD-MOF@Ru(bpy)32+ and glutaraldehyde were modified on a glassy carbon electrode (GCE) surface to provide excellent conductivity and to immobilize primary antibodies. Under the optimal experimental conditions, the established biosensor exhibited high sensitivity, a low limit of detection and a great linear range for cytokeratin 19 fragment antigen 21-1 (CYFRA21-1). Finally, this designed biosensor was further applied to the determination of CYFRA21-1 in A549 lung cancer cells. According to the results of the toxicity test, CD-MOF@Ru(bpy)32+ exhibited hypotoxicity to living bodies. These results all indicate that this biosensor has great potential for a promising approach to the evaluation of biomarkers.
Collapse
Affiliation(s)
- Yunfei Wang
- College of Chemistry and Chemical Engineering, Yantai University, Yantai, 264005, China
| | - Yixiao Li
- College of Chemistry and Chemical Engineering, Yantai University, Yantai, 264005, China
| | - Xuming Zhuang
- College of Chemistry and Chemical Engineering, Yantai University, Yantai, 264005, China.
| | - Chunyuan Tian
- College of Chemistry and Chemical Engineering, Yantai University, Yantai, 264005, China
| | - Xiuli Fu
- College of Chemistry and Chemical Engineering, Yantai University, Yantai, 264005, China
| | - Feng Luan
- College of Chemistry and Chemical Engineering, Yantai University, Yantai, 264005, China.
| |
Collapse
|
17
|
Electrochemical ultrasensitive detection of CYFRA21-1 using Ti 3C 2T x-MXene as enhancer and covalent organic frameworks as labels. Anal Bioanal Chem 2021; 413:2543-2551. [PMID: 33576855 DOI: 10.1007/s00216-021-03212-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 02/04/2023]
Abstract
The concentration level of cytokeratin fragment antigen 21-1 (CYFRA21-1) can be used as an important indicator for predicting non-small cell lung cancer (NSCLC). Here, a sandwich-type electrochemical immunosensor for ultrasensitive detection of CYFRA21-1 is developed. The sensor based on a combination of gold nanoparticle (AuNPs) decorated Ti3C2Tx-MXene (Au-Ti3C2Tx) as the substrate enhancer, and toluidine blue (TB) modified AuNPs doped covalent organic framework (COF) polymer as the signal tag (TB-Au-COF). The Au-Ti3C2Tx is used to capture numerous primary antibodies and accelerate the electron transfer rate of the substrate, while the TB-Au-COF can be applied to provide a large number of signal units TB and secondary antibodies. These features of composites endow the proposed immunosensor with high sensitivity and current response to CYFRA21-1. Under optimum conditions, the immunosensor offers a wide current response for CYFRA21-1 from 0.5-1.0 × 104 pg·mL-1 with a detection limit of 0.1 pg·mL-1. Furthermore, the biosensing platform can be applied for CYFRA21-1 detection to analyze real serum samples, providing an effective and useful avenue for the applicability of Au-Ti3C2Tx and TB-Au-COF composite materials in biosensing field.
Collapse
|
18
|
Dong J, Tong S, Shi X, Wang C, Xiao X, Ji W, Sun Y. Progastrin-Releasing Peptide Precursor and Neuron-Specific Enolase Predict the Efficacy of First-Line Treatment with Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitors Among Non-Small-Cell Lung Cancer Patients Harboring EGFR Mutations. Cancer Manag Res 2021; 12:13607-13616. [PMID: 33447080 PMCID: PMC7802014 DOI: 10.2147/cmar.s285121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/21/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose Lung cancer is the leading cause of cancer-related mortality and non-small-cell lung cancer (NSCLC) accounts for 80–90% of all lung cancers. However, biomarkers to predict the prognosis of NSCLC patients upon treatment with tyrosine kinase inhibitors remain unreliable. Different types of EGFR mutations can help predict the efficacy of tyrosine kinase inhibitor (TKI) treatment among advanced NSCLC patients harboring them. However, survival varies among individuals harboring the same mutation after targeted therapy. This study aimed to investigate the value of serum tumor markers (STMs) and EGFR mutations in the prognostic assessment of progression-free survival (PFS) in advanced-stage EGFR-mutated NSCLC. Patients and Methods A retrospective clinical review was performed on 81 NSCLC patients harboring EGFR mutations and for whom STM data, measured before commencement of first‐line treatment with tyrosine kinase inhibitors, were available. Associations among EGFR mutations, STMs, baseline clinical features, and PFS were analyzed. Kaplan−Meier method was used to plot survival curves, and Cox logistic regression models were used to identify independent prognostic factors. Results Exon 19 deletion (19-del) in EGFR, negative neuron-specific enolase (NSE), negative pro-gastrin-releasing peptide precursor (ProGRP) value, and “never smoking” status were significantly associated with improved PFS (P=0.007, P=0.001, P<0.001, and P<0.001, respectively). Multivariate Cox analysis revealed that 19-del in EGFR, never smoking, negative ProGRP value, and negative NSE were independent predictors of PFS. Conclusion This study demonstrated that 19-del in EGFR may predict longer PFS in advanced-stage EGFR-mutated NSCLC treated with TKIs. Additionally, longer PFS can be predicted by serum tumor markers with negative ProGRP value, negative NSE value before initial treatment, and “never smoking.” Therefore, in addition to the EGFR mutation type and smoking status, physicians can also prognosticate the PFS of tyrosine kinase inhibitors treatment according to the values of ProGRP and NSE before treatment.
Collapse
Affiliation(s)
- Juanjuan Dong
- Department of Oncology, Anhui Medical University-Affiliated Chaohu Hospital, Hefei 238000, Anhui, People's Republic of China
| | - Sihao Tong
- Department of Oncology, Anhui Medical University-Affiliated Chaohu Hospital, Hefei 238000, Anhui, People's Republic of China
| | - Xianfeng Shi
- Department of Oncology, Anhui Medical University-Affiliated Chaohu Hospital, Hefei 238000, Anhui, People's Republic of China
| | - Chao Wang
- Department of Oncology, Anhui Medical University-Affiliated Chaohu Hospital, Hefei 238000, Anhui, People's Republic of China
| | - Xin Xiao
- Department of Oncology, Anhui Medical University-Affiliated Chaohu Hospital, Hefei 238000, Anhui, People's Republic of China
| | - Wenping Ji
- Department of Education, Anhui Medical University-Affiliated Chaohu Hospital, Hefei 238000, Anhui, People's Republic of China
| | - Yimian Sun
- Department of Gynecology and Obstetrics, Huaian City Second People's Hospital, Huaian 223000, Jiangsu, People's Republic of China
| |
Collapse
|
19
|
Caviglia GP, Ciruolo M, Olivero A, Carucci P, Rolle E, Rosso C, Abate ML, Risso A, Ribaldone DG, Tandoi F, Saracco GM, Bugianesi E, Gaia S. Prognostic Role of Serum Cytokeratin-19 Fragment (CYFRA 21-1) in Patients with Hepatocellular Carcinoma. Cancers (Basel) 2020; 12:2776. [PMID: 32998218 PMCID: PMC7601489 DOI: 10.3390/cancers12102776] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 09/25/2020] [Indexed: 12/12/2022] Open
Abstract
Keratin 19 (K19) is a cancer stem cell marker expressed by a subpopulation of hepatocellular carcinoma (HCC), associated with tumor aggressiveness. We evaluated the prognostic value of serum K19 fragment (CYFRA 21-1), in comparison or in combination with alpha-fetoprotein (AFP) and protein induced by vitamin-K absence or antagonist-II (PIVKA-II), in patients with HCC. A total of 160 patients (28F/132M; median age 62, range 44-86 years) with a new diagnosis of HCC and available serum samples collected at tumor diagnosis were analyzed retrospectively. Median overall survival (OS) after HCC diagnosis was 35.1, 95% CI 27.1-70.5 months. Multivariate Cox regression analysis showed that CYFRA 21-1 > 2.7 ng/mL (hazard ratio (HR) = 3.39, p < 0.001), AFP > 20 ng/mL (HR = 2.27, p = 0.007), and PIVKA-II > 200 mAU/mL (HR = 2.17, p = 0.020) were independent predictors of OS. The combination of biomarkers positivity allowed us to stratify patients with HCC into four risk categories associated with a progressively lower survival probability (log-rank test, p < 0.001). CYFRA 21-1 resulted an independent prognostic factor of patients with HCC and its combination with AFP and PIVKA-II might be useful to tailor personalized treatment strategies.
Collapse
Affiliation(s)
- Gian Paolo Caviglia
- Department of Medical Sciences, University of Turin, 10100 Turin, Italy; (A.O.); (C.R.); (M.L.A.); (D.G.R.); (G.M.S.); (E.B.)
| | - Michela Ciruolo
- Division of Gastroenterology, Città della Salute e della Scienza University-Hospital, 10100 Turin, Italy; (M.C.); (P.C.); (E.R.); (A.R.)
| | - Antonella Olivero
- Department of Medical Sciences, University of Turin, 10100 Turin, Italy; (A.O.); (C.R.); (M.L.A.); (D.G.R.); (G.M.S.); (E.B.)
| | - Patrizia Carucci
- Division of Gastroenterology, Città della Salute e della Scienza University-Hospital, 10100 Turin, Italy; (M.C.); (P.C.); (E.R.); (A.R.)
| | - Emanuela Rolle
- Division of Gastroenterology, Città della Salute e della Scienza University-Hospital, 10100 Turin, Italy; (M.C.); (P.C.); (E.R.); (A.R.)
| | - Chiara Rosso
- Department of Medical Sciences, University of Turin, 10100 Turin, Italy; (A.O.); (C.R.); (M.L.A.); (D.G.R.); (G.M.S.); (E.B.)
| | - Maria Lorena Abate
- Department of Medical Sciences, University of Turin, 10100 Turin, Italy; (A.O.); (C.R.); (M.L.A.); (D.G.R.); (G.M.S.); (E.B.)
| | - Alessandra Risso
- Division of Gastroenterology, Città della Salute e della Scienza University-Hospital, 10100 Turin, Italy; (M.C.); (P.C.); (E.R.); (A.R.)
| | - Davide Giuseppe Ribaldone
- Department of Medical Sciences, University of Turin, 10100 Turin, Italy; (A.O.); (C.R.); (M.L.A.); (D.G.R.); (G.M.S.); (E.B.)
- Division of Gastroenterology, Città della Salute e della Scienza University-Hospital, 10100 Turin, Italy; (M.C.); (P.C.); (E.R.); (A.R.)
| | - Francesco Tandoi
- Liver Transplant Unit, General Surgery 2U, Department of Surgical Sciences, Città della Salute e della Scienza University-Hospital, 10100 Turin, Italy;
| | - Giorgio Maria Saracco
- Department of Medical Sciences, University of Turin, 10100 Turin, Italy; (A.O.); (C.R.); (M.L.A.); (D.G.R.); (G.M.S.); (E.B.)
- Division of Gastroenterology, Città della Salute e della Scienza University-Hospital, 10100 Turin, Italy; (M.C.); (P.C.); (E.R.); (A.R.)
| | - Elisabetta Bugianesi
- Department of Medical Sciences, University of Turin, 10100 Turin, Italy; (A.O.); (C.R.); (M.L.A.); (D.G.R.); (G.M.S.); (E.B.)
- Division of Gastroenterology, Città della Salute e della Scienza University-Hospital, 10100 Turin, Italy; (M.C.); (P.C.); (E.R.); (A.R.)
| | - Silvia Gaia
- Division of Gastroenterology, Città della Salute e della Scienza University-Hospital, 10100 Turin, Italy; (M.C.); (P.C.); (E.R.); (A.R.)
| |
Collapse
|
20
|
Hu Y, Ferdosi S, Kapuruge EP, Diaz de Leon JA, Stücker I, Radoï L, Guénel P, Borges CR. Diagnostic and Prognostic Performance of Blood Plasma Glycan Features in the Women Epidemiology Lung Cancer (WELCA) Study. J Proteome Res 2019; 18:3985-3998. [PMID: 31566983 DOI: 10.1021/acs.jproteome.9b00457] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Lung cancer is the leading cause of cancer death in women living in the United States, which accounts for approximately the same percentage of cancer deaths in women as breast, ovary, and uterine cancers combined. Targeted blood plasma glycomics represents a promising source of noninvasive diagnostic and prognostic biomarkers for lung cancer. Here, 208 samples from lung cancer patients and 207 age-matched controls enrolled in the Women Epidemiology Lung Cancer (WELCA) study were analyzed by a bottom-up glycan "node" analysis approach. Glycan features, quantified as single analytical signals, including 2-linked mannose, α2-6 sialylation, β1-4 branching, β1-6 branching, 4-linked GlcNAc, and antennary fucosylation, exhibited abilities to distinguish cases from controls (ROC AUCs: 0.68-0.92) and predict survival in patients (hazard ratios: 1.99-2.75) at all stages. Notable alterations of glycan features were observed in stages I-II. Diagnostic and prognostic glycan features were mostly independent of smoking status, age, gender, and histological subtypes of lung cancer.
Collapse
Affiliation(s)
- Yueming Hu
- School of Molecular Sciences and The Biodesign Institute , Arizona State University , Tempe , Arizona 85287 , United States
| | - Shadi Ferdosi
- School of Molecular Sciences and The Biodesign Institute , Arizona State University , Tempe , Arizona 85287 , United States
| | - Erandi P Kapuruge
- School of Molecular Sciences and The Biodesign Institute , Arizona State University , Tempe , Arizona 85287 , United States
| | - Jesús Aguilar Diaz de Leon
- School of Molecular Sciences and The Biodesign Institute , Arizona State University , Tempe , Arizona 85287 , United States
| | - Isabelle Stücker
- CESP (Center for Research in Epidemiology and Population Health), Cancer and Environment Team, INSERM UMS1018 , University Paris-Sud, University Paris-Saclay , 94800 Villejuif, France
| | - Loredana Radoï
- CESP (Center for Research in Epidemiology and Population Health), Cancer and Environment Team, INSERM UMS1018 , University Paris-Sud, University Paris-Saclay , 94800 Villejuif, France
- Faculty of Dental Surgery , University Paris Descartes , 75006 Paris , France
| | - Pascal Guénel
- CESP (Center for Research in Epidemiology and Population Health), Cancer and Environment Team, INSERM UMS1018 , University Paris-Sud, University Paris-Saclay , 94800 Villejuif, France
| | - Chad R Borges
- School of Molecular Sciences and The Biodesign Institute , Arizona State University , Tempe , Arizona 85287 , United States
| |
Collapse
|
21
|
Kanaji N, Kadota K, Tadokoro A, Inoue T, Watanabe N, Haba R, Kadowaki N, Ishii T. Serum CYFRA 21-1 but not Vimentin is Associated with Poor Prognosis in Advanced Lung Cancer Patients. Open Respir Med J 2019; 13:31-37. [PMID: 31908686 PMCID: PMC6918537 DOI: 10.2174/1874306401913010031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/29/2019] [Accepted: 06/15/2019] [Indexed: 11/22/2022] Open
Abstract
Background Cytokeratins and Vimentin are intermediate filament proteins. Vimentin expression in tissue samples has been reported to be associated with a poor prognosis in non-small cell lung cancer patients who underwent surgery. CYFRA 21-1 (Cytokeratin 19 Fragment) is a well known tumor marker. Objective This study aimed to investigate the usefulness of serum vimentin as a tumor marker and significance of CYFRA 21-1 and vimentin expression on prognosis of advanced lung cancer patients. Methods One hundred and four advanced lung cancer patients and 19 non-lung cancer patients were included. A total of 157 clinical samples obtained from 113 patients was used for immunostaining of vimentin and measurements of CYFRA 21-1 and vimentin concentrations. Results Compared to low concentration, high concentration of serum CYFRA 21-1 was associated with shorter overall survival in lung cancer patients. However, there was no difference in the serum vimentin concentration between the patients with lung cancer and those with non-lung cancer. No difference in vimentin concentration was observed between the malignant and non-malignant pleural effusions. Immunostaining revealed that of the 43 tumor samples, 21 were positive and 22 were negative for vimentin. No significant difference was found in overall survival between patients with positive and negative for vimentin. Conclusion An elevated serum CYFRA 21-1 concentration was associated with shorter overall survival in advanced lung cancer patients. However, serum vimentin was not as useful as a tumor marker of lung cancer. The vimentin positivity in tumor samples might not predict patients' prognosis in patients with advanced lung cancer.
Collapse
Affiliation(s)
- Nobuhiro Kanaji
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Kyuichi Kadota
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Akira Tadokoro
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Takuya Inoue
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Naoki Watanabe
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Reiji Haba
- Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Norimitsu Kadowaki
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Tomoya Ishii
- Department of Internal Medicine, Division of Hematology, Rheumatology and Respiratory Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| |
Collapse
|
22
|
Muley T, He Y, Rolny V, Wehnl B, Escherich A, Warth A, Stolp C, Schneider MA, Meister M, Herth FJ, Dayyani F. Potential for the blood-based biomarkers cytokeratin 19 fragment (CYFRA 21-1) and human epididymal protein 4 (HE4) to detect recurrence during monitoring after surgical resection of adenocarcinoma of the lung. Lung Cancer 2019; 130:194-200. [PMID: 30885344 DOI: 10.1016/j.lungcan.2019.02.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/14/2019] [Accepted: 02/18/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The biomarkers cytokeratin 19 fragment (CYFRA 21-1) and human epididymis protein 4 (HE4) are useful in the diagnosis, prognosis, and monitoring of non-small cell lung cancer (NSCLC), but their combination has not been investigated yet. The objective of this analysis was to evaluate the ability of CYFRA 21-1 and HE4 to predict recurrence as part of follow-up monitoring in patients with adenocarcinoma (ADC) of the lung. MATERIALS AND METHODS Serum samples were collected from patients with stage I-IIIA ADC preoperatively and during follow-up at 3, 6, 12, 18, and 24 months and then every 6-12 months up to 5 years post-R0 resection. Samples were analyzed for CYFRA 21-1 and HE4 via electrochemiluminescence immunoassay. All cases of disease recurrence were verified by imaging. The diagnostic performance of CYFRA 21-1, HE4, and their combination to predict recurrence was assessed by Receiver Operating Characteristic (ROC) and corresponding area under the curve (AUC). RESULTS 115 patients with ADC were included (N = 612 biomarker measurements); median age was 63 years; most had stage I-II disease (n = 97; 84.3%). All patients underwent surgical resection; 44 patients (38%) also received adjuvant chemotherapy and 16 (14%) received radiation therapy. At the median timepoint for the last blood sample collection (37 months), 31 patients (27%) had experienced recurrence. Both CYFRA 21-1 and HE4 were able to detect recurrence (AUC and 95% confidence interval [CI]): 75.9% (66.0-85.8%) and 75.4% (65.9-84.8%), respectively, but this increased with the combination (78.8% [69.0-88.6%]). At a sensitivity of 80%, the respective specificities (95% CI) for CYFRA 21-1, HE4, and the combination were 57.1% (53.0-61.2%), 57.1% (53.0-61.2%), and 69.7% (65.8-73.4%). CONCLUSION Serial measurements of serum CYFRA 21-1 and HE4 levels could provide a valuable method for follow-up monitoring of patients with ADC to detect recurrence.
Collapse
Affiliation(s)
- Thomas Muley
- Translational Research Unit, Thoraxklinik at University Hospital Heidelberg, Germany; Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Germany.
| | - Ying He
- Roche Diagnostics GmbH, Penzberg, Germany.
| | | | | | | | - Arne Warth
- Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Germany; Pathological Institute, University of Heidelberg, Heidelberg, Germany.
| | - Christa Stolp
- Translational Research Unit, Thoraxklinik at University Hospital Heidelberg, Germany.
| | - Marc A Schneider
- Translational Research Unit, Thoraxklinik at University Hospital Heidelberg, Germany; Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Germany.
| | - Michael Meister
- Translational Research Unit, Thoraxklinik at University Hospital Heidelberg, Germany; Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Germany.
| | - Felix J Herth
- Translational Lung Research Center (TLRC) Heidelberg, Member of the German Center for Lung Research (DZL), Germany; Department of Pneumology and Critical Care Medicine, Thoraxklinik at University Hospital Heidelberg, Germany.
| | | |
Collapse
|
23
|
Abtahi S, Malekzadeh M, Nikravan G, Ghaderi A. Authors' Reply. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2018; 9:158-159. [PMID: 29995023 PMCID: PMC6466978 DOI: 10.15171/ijoem.2018.1356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 05/19/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Shabnam Abtahi
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahyar Malekzadeh
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ghafour Nikravan
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Ghaderi
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
24
|
Marsh GM, Bernal A, Egnot NS, Kreider M. Comments on the Measurement of Lung Cancer Tumor Markers in Workers of a Glass Wool Company. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2018; 9. [PMID: 29995022 PMCID: PMC6466980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | | | - Natalie Suder Egnot
- Correspondence to Natalie Suder Egnot, DrPH, Health Scientist, Cardno ChemRisk, USA E-mail:
| | | |
Collapse
|
25
|
Increased CYFRA 21-1, CEA and NSE are Prognostic of Poor Outcome for Locally Advanced Squamous Cell Carcinoma in Lung: A Nomogram and Recursive Partitioning Risk Stratification Analysis. Transl Oncol 2018; 11:999-1006. [PMID: 29958123 PMCID: PMC6040260 DOI: 10.1016/j.tranon.2018.05.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/24/2018] [Accepted: 05/24/2018] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES This study aimed to: (1) assess the prognostic significance of serum tumor markers in locally advanced squamous cell carcinoma in lung (LA-SCCL); (2) generate a nomogram to predict the overall survival (OS) and (3) identify a prognostic stratification to assist the therapeutic decision-making. METHODS LA-SCCL patients receiving definitive radiotherapy and baseline tumor marker measurement were eligible for this retrospective study. Cox proportional hazards regression was used to determine independent factors associated with various survival indexes and a nomogram was created to estimate the 5-year OS probability for individual patient. The identified prognostic factors were recruited into a recursive partitioning analysis (RPA) for OS to stratify patients with distinct outcome. RESULTS A total of 224 patients were eligible for analysis. Increased cytokeratin-19 fragment (CYFRA 21-1) was independently associated with inferior OS, progression free survival (PFS) and a borderline decreased local-regional progression free survival (LRPFS). Elevated carcino-embryonic antigen (CEA) served as an unfavorable determinant for OS and increased neuron-specific enolase (NSE) was predictive of poor distant metastasis free survival (DMFS). A nomogram integrating KPS, TNM stage, CEA and CYFRA 21-1 was created, resulting in a c-index of 0.62. RPA identified 4 prognostic classifications, with median OS of 27.6, 19.9, 17.3 and 10.9 months for low, intermediate, high and very-high risk groups, respectively. CONCLUSIONS Baseline tumor marker panel including CYFRA 21-1, CEA and NSE can be prognostic of outcome for LA-SCCL receiving definitive radiotherapy. The RPA identified four prognostic subgroups, which could assist personalized therapy and clinical trial design in LA-SCCL.
Collapse
|
26
|
Salem A, Mistry H, Backen A, Hodgson C, Koh P, Dean E, Priest L, Haslett K, Trigonis I, Jackson A, Asselin MC, Dive C, Renehan A, Faivre-Finn C, Blackhall F. Cell Death, Inflammation, Tumor Burden, and Proliferation Blood Biomarkers Predict Lung Cancer Radiotherapy Response and Correlate With Tumor Volume and Proliferation Imaging. Clin Lung Cancer 2018; 19:239-248.e7. [PMID: 29398577 PMCID: PMC5927801 DOI: 10.1016/j.cllc.2017.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 11/21/2017] [Accepted: 12/01/2017] [Indexed: 12/25/2022]
Abstract
INTRODUCTION There is an unmet need to develop noninvasive biomarkers to stratify patients in drug-radiotherapy trials. In this pilot study we investigated lung cancer radiotherapy response and toxicity blood biomarkers and correlated findings with tumor volume and proliferation imaging. PATIENTS AND METHODS Blood samples were collected before and during (day 21) radiotherapy. Twenty-six cell-death, hypoxia, angiogenesis, inflammation, proliferation, invasion, and tumor-burden biomarkers were evaluated. Clinical and laboratory data were collected. Univariate analysis was performed on small-cell and non-small-cell lung cancer (NSCLC) whereas multivariate analysis focused on NSCLC. RESULTS Blood samples from 78 patients were analyzed. Sixty-one (78.2%) harbored NSCLC, 48 (61.5%) received sequential chemoradiotherapy. Of tested baseline biomarkers, undetectable interleukin (IL)-1b (hazard ratio [HR], 4.02; 95% confidence interval [CI], 2.04-7.93; P < .001) was the only significant survival covariate. Of routinely collected laboratory tests, high baseline neutrophil count was a significant survival covariate (HR, 1.07; 95% CI, 1.02-1.11; P = .017). Baseline IL-1b and neutrophil count were prognostic for survival in a multivariate model. The addition of day-21 cytokeratin-19 antigen modestly improved this model's survival prediction (concordance probability, 0.75-0.78). Chemotherapy (P < .001) and baseline keratinocyte growth factor (P = .019) predicted acute esophagitis, but only chemotherapy remained significant after Bonferroni correction. Baseline angioprotein-1 and hepatocyte growth factor showed a direct correlation with tumor volume whereas changes in vascular cell adhesion molecule 1 showed significant correlations with 18F-fluorothymidine (FLT) positron emission tomography (PET). CONCLUSION Select biomarkers are prognostic after radiotherapy in this lung cancer series. The correlation between circulating biomarkers and 18F-FLT PET is shown, to our knowledge for the first time, highlighting their potential role as imaging surrogates.
Collapse
Affiliation(s)
- Ahmed Salem
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom.
| | - Hitesh Mistry
- Division of Pharmacy, University of Manchester, Manchester, United Kingdom
| | - Alison Backen
- Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Clare Hodgson
- Clinical and Experimental Pharmacology Group, Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Pek Koh
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Emma Dean
- Early Phase Oncology, AstraZeneca, Cambridge, United Kingdom
| | - Lynsey Priest
- Clinical and Experimental Pharmacology Group, Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Kate Haslett
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Ioannis Trigonis
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Alan Jackson
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Marie-Claude Asselin
- Division of Informatics, Imaging and Data Sciences, University of Manchester, Manchester, United Kingdom
| | - Caroline Dive
- Clinical and Experimental Pharmacology Group, Cancer Research UK Manchester Institute, Manchester, United Kingdom
| | - Andrew Renehan
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Corinne Faivre-Finn
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Fiona Blackhall
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| |
Collapse
|
27
|
A sandwich-type electrochemical immunoassay for ultrasensitive detection of non-small cell lung cancer biomarker CYFRA21-1. Bioelectrochemistry 2018; 120:183-189. [DOI: 10.1016/j.bioelechem.2017.11.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 12/20/2022]
|
28
|
Yu Z, Zhang G, Yang M, Zhang S, Zhao B, Shen G, Chai Y. Systematic review of CYFRA 21-1 as a prognostic indicator and its predictive correlation with clinicopathological features in Non-small Cell Lung Cancer: A meta-analysis. Oncotarget 2018; 8:4043-4050. [PMID: 28008142 PMCID: PMC5354811 DOI: 10.18632/oncotarget.14022] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/02/2016] [Indexed: 12/14/2022] Open
Abstract
AIM To evaluate the value of Cytokeratin 19 fragment for its survival prognostic indicator and predictive correlation with clinicopathological features in Non-small Cell Lung Cancer. METHODS Eligible studies or databases for articles were retrieved via search systematically. Pooled effect was calculated to evaluate the association between Cytokeratin 19 fragment level and long-term overall survival, as well as the tumor clinicopathological features in Non-small Cell Lung Cancer patients. A fixed-effects or random-effects model was used to calculate the Pooled risk ratios (RRs) and corresponding 95 % confidence intervals (CIs). RESULTS Six studies were up to the selection criteria. This meta-analysis indicated that Cytokeratin 19 fragment high level expression correlated with lower 2-year overall survival (RR =0.47; 95%CI: 0.28-0.79), higher Tumor Node Metastasis stage (II+III+IV) (RR =1.43; 95%CI: 1.15-1.76) in Non-small Cell Lung Cancer. The pooled RR estimates indicated that there is no statistical significance of Cytokeratin 19 fragment level expression in the advanced Non-small Cell Lung Cancer (IIIB+IV) (RR =1.43, 95% CI: 0.85-2.43). CONCLUSION Cytokeratin 19 fragment is a negative prognosis indicator and its high level expression indicates higher Tumor Node Metastasis pathological stage (II+III+IV) in Non-small Cell Lung Cancer. In advanced Non-small Cell Lung Cancer, the level of serum Cytokeratin 19 fragment appears to provide more prognostic information than it does for clinical Tumor Node Metastasis stage information. Further studies are required to confirm our results.
Collapse
Affiliation(s)
- Zipu Yu
- Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Guofei Zhang
- Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Maoying Yang
- Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Sai Zhang
- Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Baiqin Zhao
- Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Gang Shen
- Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Ying Chai
- Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China
| |
Collapse
|
29
|
Zhao B, Zhang M, Liu D, Ren Y, Xie J, Liang Y, Yang Z. Establishment of reference interval for the tumour marker serum CYFRA 21-1 in healthy Chinese Han ethnic adults. Scandinavian Journal of Clinical and Laboratory Investigation 2018; 78:171-174. [PMID: 29336188 DOI: 10.1080/00365513.2018.1426105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Our aim was to establish the reference interval (RI) for serum CYFRA 21-1 in healthy Chinese Han ethnic adults, since there has been no report about it. METHODS After screening, 9954 healthy Chinese Han adults (age range 18-95 years) were recruited, including 6639 (66.7%) males and 3315 (33.3%) females. Electrochemiluminescence immunoassay was used to measure serum CYFRA21-1. The RI was defined by nonparametric 95% percentile interval. RESULTS The distribution for serum CYFRA21-1 level was non-Gaussian. The RI for healthy Chinese Han adults calculated by nonparametric method was 0-4.47 ng/ml in this study, higher than that recommended by Roche Diagnostics GmbH (≤3.3 ng/ml). The reference values were higher in males than females before 50 years of age, although the difference was hardly seen after 50 years of age. The reference value increased with age in both males and females. Of slight difference, the increase of male reference value was obvious at 60-69 and more than 80 years of age, while that of female obvious at 50-69 and more than 80 years of age. CONCLUSIONS We establish the RI for serum CYFRA21-1 in healthy Chinese Han population, which is higher than that recommended by Roche Diagnostics GmbH. Furthermore, our study suggests that it is necessary to establish the age- and sex-specific RIs for serum CYFRA21-1.
Collapse
Affiliation(s)
- Bing Zhao
- a Department of Laboratory Medicine , Taizhou First People's Hospital, Huangyan Hospital Affiliated to Wenzhou Medical University , Zhejiang , China
| | - Miaomiao Zhang
- a Department of Laboratory Medicine , Taizhou First People's Hospital, Huangyan Hospital Affiliated to Wenzhou Medical University , Zhejiang , China
| | - Donghong Liu
- a Department of Laboratory Medicine , Taizhou First People's Hospital, Huangyan Hospital Affiliated to Wenzhou Medical University , Zhejiang , China
| | - Yingpeng Ren
- a Department of Laboratory Medicine , Taizhou First People's Hospital, Huangyan Hospital Affiliated to Wenzhou Medical University , Zhejiang , China
| | - Jing Xie
- a Department of Laboratory Medicine , Taizhou First People's Hospital, Huangyan Hospital Affiliated to Wenzhou Medical University , Zhejiang , China
| | - Yan Liang
- b Department of Laboratory Diagnostics , Changzheng Hospital, Second Military Medical University , Shanghai , China
| | - Zaixing Yang
- a Department of Laboratory Medicine , Taizhou First People's Hospital, Huangyan Hospital Affiliated to Wenzhou Medical University , Zhejiang , China
| |
Collapse
|
30
|
Abtahi S, Malekzadeh M, Nikravan G, Ghaderi A. Measurement of Lung Cancer Tumor Markers in a Glass Wool Company Workers Exposed to Respirable Synthetic Vitreous Fiber and Dust. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2018; 9:23-31. [PMID: 29319052 PMCID: PMC6466973 DOI: 10.15171/ijoem.2018.1147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/18/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Occupational exposures to respirable synthetic vitreous fiber (SVF) and dust are associated with many lung diseases including lung cancer. Low-dose computed tomography is used for screening patients who are highly suspicious of having lung carcinoma. However, it seems not to be cost-effective. Serum biomarkers could be a useful tool for the surveillance of occupational exposure, by providing the possibility of diagnosing lung cancer in its early stages. OBJECTIVE To determine if serum carcinoembryonic antigen (CEA) and cytokeratin fragment (CYFRA) 21-1 levels in workers exposed more than normal population to respirable SVF and dust may be used as indicators of progression towards lung cancer. METHODS An analytic cross-sectional study, including 145 personnel of a glass wool company, along with 25 age-matched healthy individuals, was conducted to investigate the relationship between occupational exposure to respirable SVFs and dust and serum levels of two lung/pleura serum tumor markers, CEA and CYFRA 21-1, measured by ELISA. RESULTS Individuals exposed to higher than the recommended levels of respirable SVF had higher serum concentrations of CEA and CYFRA 21-1, compared to controls (p=0.008 and 0.040, respectively), as well as in comparison to those exposed to lower than recommended OSHA levels (p=0.046 and 0.033, respectively). Workers with >9 years work experience, had significantly (p=0.045) higher levels of serum CYFRA 21-1 than those with ≤9 years of experience. CONCLUSION It seems that working for >9 years in sites with detectable levels of respirable SVF and dust would increase the levels of known lung cancer serum tumor markers. Transferring these workers to sites with respirable SVF concentrations lower than the limit of detection in the air is recommended.
Collapse
Affiliation(s)
- Shabnam Abtahi
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahyar Malekzadeh
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Abbas Ghaderi
- Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
31
|
A sensitive label-free electrochemical immunosensor for detection of cytokeratin 19 fragment antigen 21-1 based on 3D graphene with gold nanopaticle modified electrode. Talanta 2017; 178:122-128. [PMID: 29136801 DOI: 10.1016/j.talanta.2017.09.020] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/31/2017] [Accepted: 09/07/2017] [Indexed: 01/31/2023]
Abstract
Previous studies have confirmed that cytokeratin 19 fragment antigen 21-1 (CYFRA 21-1) serves as a powerful biomarker in non-small cell lung cancer (NSCLC). Herein, we report for the first time a label-free electrochemical immunosensor for sensitive and selective detection of tumor marker CYFRA21-1. In this work, three-dimensional graphene @ gold nanoparticles (3D-G@Au) nanocomposite was modified on the glassy carbon electrode (GCE) surface to enhance the conductivity of immunosensor. The anti-CYFRA21-1 captured and fixed on the modified GCE through the cross-linking of chitosan (CS), glutaraldehyde (GA) and anti-CYFRA21-1. The differential pulse voltammetry (DPV) peak current change due to the specific interaction between anti-CYFRA21-1 and CYFRA21-1 on the modified electrode surface was utilized to detect CYFRA21-1. Under optimized conditions, the proposed electrochemical immunosensor was employed to detect CYFRA21-1 and exhibited a wide linear range of 0.25-800ngmL-1 and low detection limit of 100pgmL-1 (S/N = 3). Moreover, the recovery rates of serum samples were in the range from 95.2% to 108.7% and the developed immunosensor also shows a good correlation (less than 6.6%) with enzyme-linked immunosorbent assay (ELISA) in the detection of clinical serum samples. Therefore, it is expected that the proposed immunosensor based on a 3D-G@Au has great potential in clinical medical diagnosis of CYFRA21-1.
Collapse
|
32
|
MUC1 overexpression predicts worse survival in patients with non-small cell lung cancer: evidence from an updated meta-analysis. Oncotarget 2017; 8:90315-90326. [PMID: 29163831 PMCID: PMC5685752 DOI: 10.18632/oncotarget.19861] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 07/18/2017] [Indexed: 01/11/2023] Open
Abstract
Background Previous studies on the prognostic role of MUC1 expression in non-small cell lung cancer (NSCLC) remain controversial. We conducted a meta-analysis to appraise the clinicopathological and prognostic effect of MUC1 in NSCLC patients. Materials and Methods Searches of PubMed, EMBASE and CNKI (Chinese National Knowledge Infrastructure) were conducted and relevant studies were extracted. The pooled hazard ratio (HR) or odds ratio (OR) with 95% confidence intervals (CIs) were used to estimate effects. Heterogeneity among studies and publication bias were also evaluated. Results A total of 15 studies with 1,682 patients were included in this meta-analysis. The pooled HRs indicated that elevated MUC1 expression was associated with poorer overall survival (HR = 2.12, 95% CI: 1.47–3.05; P < 0.001) and progression-free survival (HR = 2.00, 95% CI: 1.53-2.62; P < 0.001) in patients with NSCLC. Significant associations were also found in patients treated with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) (HR = 3.16, 95% CI: 2.21–4.52, P < 0.001) and with a platinum-based regimen (HR = 4.35, 95% CI: 2.45–7.72, P < 0.001). Additionally, MUC1 overexpression was significantly associated with performance status (OR = 2.32, 95% CI: 1.13–4.73, P = 0.021). Conclusions MUC1 could be a valuable biomarker of the prognoses of NSCLC patients.
Collapse
|
33
|
Liu ZL, Wu J, Wang LX, Yang JF, Xiao GM, Sun HP, Chen YJ. Knockdown of Upregulated Gene 11 (URG11) Inhibits Proliferation, Invasion, and β-Catenin Expression in Non-Small Cell Lung Cancer Cells. Oncol Res 2017; 24:197-204. [PMID: 27458101 PMCID: PMC7838721 DOI: 10.3727/096504016x14648701447850] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Upregulated gene 11 (URG11), a new gene upregulated by hepatitis B virus X protein, was found to be involved in the development and progression of several tumors. However, the role of URG11 in human non-small cell lung cancer (NSCLC) has not yet been determined. Therefore, the aim of the present study was to explore the role of URG11 in human NSCLC. Our results found that URG11 was highly expressed in human NSCLC tissues compared with matched normal lung tissues, and higher levels were found in NSCLC cell lines in comparison to the normal lung cell line. Moreover, we also found that knockdown of URG11 significantly inhibited proliferation, migration/invasion of NSCLC cells, as well as suppressed tumor growth in vivo. Furthermore, knockdown of URG11 suppressed the expression of β-catenin, c-Myc, and cyclin D1 in NSCLC cells. Taken together, the study reported here provided evidence that URG11 downregulation suppresses proliferation, invasion, and β-catenin expression in NSCLC cells. Thus, URG11 may be a novel potential therapeutic target for NSCLC.
Collapse
Affiliation(s)
- Zhe-Liang Liu
- The First Department of Thoracic Surgery, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | | | | | | | | | | | | |
Collapse
|
34
|
History, molecular features, and clinical importance of conventional serum biomarkers in lung cancer. Surg Today 2017; 47:1037-1059. [DOI: 10.1007/s00595-017-1477-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 01/04/2017] [Indexed: 01/27/2023]
|
35
|
Carvalho S, Troost EGC, Bons J, Menheere P, Lambin P, Oberije C. Prognostic value of blood-biomarkers related to hypoxia, inflammation, immune response and tumour load in non-small cell lung cancer - A survival model with external validation. Radiother Oncol 2016; 119:487-94. [PMID: 27139126 DOI: 10.1016/j.radonc.2016.04.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 04/04/2016] [Accepted: 04/16/2016] [Indexed: 12/12/2022]
Abstract
AIM Improve the prognostic prediction of clinical variables for non-small cell lung cancer (NSCLC), by selecting from blood-biomarkers, non-invasively describing hypoxia, inflammation and tumour load. METHODS Model development and validation included 182 and 181 inoperable stage I-IIIB NSCLC patients treated radically with radiotherapy (55.2%) or chemo-radiotherapy (44.8%). Least absolute shrinkage and selection operator (LASSO), selected from blood-biomarkers related to hypoxia [osteopontin (OPN) and carbonic anhydrase IX (CA-IX)], inflammation [interleukin-6 (IL-6), IL-8, and C-reactive protein (CRP)], and tumour load [carcinoembryonic antigen (CEA), and cytokeratin fragment 21-1 (Cyfra 21-1)]. Sequent model extension selected from alpha-2-macroglobulin (α2M), serum interleukin-2 receptor (sIL2r), toll-like receptor 4 (TLR4), and vascular endothelial growth factor (VEGF). Discrimination was reported by concordance-index. RESULTS OPN and Cyfra 21-1 (hazard ratios of 3.3 and 1.7) significantly improved a clinical model comprising gender, World Health Organization performance-status, forced expiratory volume in 1s, number of positive lymph node stations, and gross tumour volume, from a concordance-index of 0.66 to 0.70 (validation=0.62 and 0.66). Extension of the validated model yielded a concordance-index of 0.67, including α2M, sIL2r and VEGF (hazard ratios of 4.6, 3.1, and 1.4). CONCLUSION Improvement of a clinical model including hypoxia and tumour load blood-biomarkers was validated. New immunological markers were associated with overall survival. Data and models can be found at www.cancerdata.org (http://dx.doi.org/10.17195/candat.2016.04.1) and www.predictcancer.org.
Collapse
Affiliation(s)
- Sara Carvalho
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center (MUMC+), The Netherlands.
| | - Esther G C Troost
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center (MUMC+), The Netherlands; Institute of Radiooncology, Helmholtz Zentrum Dresden-Rossendorf, Germany; OncoRay, National Center for Radiation Research in Oncology, Dresden, Germany; Department of Radiooncology, Universitätsklinik Carl Gustav Carus der Technischen Universität Dresden, Germany
| | - Judith Bons
- Central Diagnostic Laboratory, Laboratory for Immunodiagnostics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Paul Menheere
- Central Diagnostic Laboratory, Laboratory for Immunodiagnostics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Philippe Lambin
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center (MUMC+), The Netherlands
| | - Cary Oberije
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center (MUMC+), The Netherlands
| |
Collapse
|
36
|
Aoyagi K, Kizaki J, Isobe T, Akagi Y. Long-term survival of a patient with small cell carcinoma of the stomach with metachronous lung metastases treated by multimodal therapy: a case report. Surg Case Rep 2015; 1:125. [PMID: 26943449 PMCID: PMC4690825 DOI: 10.1186/s40792-015-0126-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 12/20/2015] [Indexed: 12/16/2022] Open
Abstract
A 69-year-old man was referred to our institution for treatment of gastric cancer. Type 2 gastric cancer was found on the anterior wall of the lower body of the stomach.The patient underwent distal gastrectomy, D2 lymph node dissection, and Roux-en-Y reconstruction with curative resection. The tumor was diagnosed as a small cell carcinoma of the stomach. Recurrence occurred in the lung after surgery. The patient underwent several chemoradiation therapy regimens, including cisplatin + irinotecan + radiation, S-1 + paclitaxel, amrubicin, carboplatin + etoposide, nogitecan, and docetaxel for lung metastases and radiation for brain and bone metastases for 43 months. He finally died of brain metastases 74 months after surgery (47 months after recognition of the lung metastases). Long continuous multimodal treatment including surgery, regimens for small cell lung cancer, S-1, taxanes, and radiation was thought to prolong the survival of this man with small cell carcinoma of the stomach.
Collapse
Affiliation(s)
- Keishiro Aoyagi
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Junya Kizaki
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Taro Isobe
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| |
Collapse
|
37
|
Abstract
Lung cancer is the most frequently occurring cancer in the world and continually leads in mortality among cancers. The overall 5-year survival rate for lung cancer has risen only 4% (from 12% to 16%) over the past 4 decades, and late diagnosis is a major obstacle in improving lung cancer prognosis. Survival of patients undergoing lung resection is greater than 80%, suggesting that early detection and diagnosis of cancers before they become inoperable and lethal will greatly improve mortality. Lung cancer biomarkers can be used for screening, detection, diagnosis, prognosis, prediction, stratification, therapy response monitoring, and so on. This review focuses on noninvasive diagnostic and prognostic biomarkers. For that purpose, our discussion in this review will focus on biological fluid-based biomarkers. The body fluids include blood (serum or plasma), sputum, saliva, BAL, pleural effusion, and VOC. Since it is rich in different cellular and molecular elements and is one of the most convenient and routine clinical procedures, serum or plasma is the main source for the development and validation of many noninvasive biomarkers. In terms of molecular aspects, the most widely validated ones are proteins, some of which are used in the clinical sector, though in limited accessory purposes. We will also discuss the lung cancer (protein) biomarkers in clinical trials and currently in the validation phase with hundreds of samples. After proteins, we will discuss microRNAs, methylated DNA, and circulating tumor cells, which are being vigorously developed and validated as potential lung cancer biomarkers. The main aim of this review is to provide researchers and clinicians with an understanding of the potential noninvasive lung cancer biomarkers in biological fluids that have recently been discovered.
Collapse
|