Journal
CANCER
Volume 121, Issue -, Pages 3113-3121Publisher
WILEY
DOI: 10.1002/cncr.29551
Keywords
biomarker; delayed diagnosis; non-small cell lung cancer; progastrin-releasing peptide (ProGRP); small cell lung cancer
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Funding
- 973 Program of the Ministry of Science and Technology of China [2012CB933304]
- Shanghai Natural Science Foundation [13ZR1452400]
- Shanghai Municipal Leading Academic Discipline Project [B115]
- National Key Scientific and Technology Support Program (Collaborative Innovation of Clinical Research for Chronic Obstructive Pulmonary Disease and Lung Cancer) [2013BAI09B09]
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BACKGROUNDThis study applied a combined cancer biomarker panel to clinically identify small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) in a high-risk population. METHODSThe serum levels of 4 biomarkers (progastrin-releasing peptide [ProGRP], carcinoembryonic antigen [CEA], squamous cell carcinoma antigen [SCC], and cytokeratin 19 fragment [CYFRA21-1]) were determined in 153 patients with a high risk of lung cancer (12 with a new diagnosis of SCLC, 52 with NSCLC, and 89 without lung cancer). Information about diagnosis delays was collected through interviews of all participants. RESULTSSignificantly higher serum levels of ProGRP (P<.0001) were found among the SCLC patients versus the rest of the population. A receiver operating characteristic curve analysis established the cutoff values of ProGRP, CEA, SCC, and CYFRA21-1 as 300 pg/mL, 7.3 ng/mL, 3 ng/mL, and 6.5 ng/mL, respectively. The sensitivity and specificity of ProGRP in diagnosing SCLC were 75% and 100%, respectively. Among the 14 lung cancer patients with a false-negative computed tomography (CT) result, the diagnostic panel detected 8 additional cancers. CONCLUSIONSThis panel increased the diagnostic specificity for high-risk subjects (those with renal failure being excluded), and auxiliary to a CT scan, it increased the sensitivity for patients with lung cancer. These results might be applied to shorten the diagnosis delay at health care institutions in China. Cancer 2015;121:3113-21. (c) 2015 American Cancer Society.
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