Zhang Dai, Ren Wei-Hong, Gao Yun, Wang Nian-Yue, Wu Wen-Jun
Department of Clinical Laboratory, the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China.
Asian Pac J Cancer Prev. 2013;14(7):4215-21. doi: 10.7314/apjcp.2013.14.7.4215.
Lung cancer is prevalent worldwide and improvements in timely and effective diagnosis are need. Pentraxin-3 as a novel serum marker for lung cancer (LC) has not been validated in large cohort studies. The aim of the study was to assess its clinical value in diagnosis and prognosis.
We analyzed serum PTX-3 levels in a total of 1,605 patients with LC, benign lung diseases and healthy controls, as well as 493 non- lung cancer patients including 12 different types of cancers. Preoperative and postoperative data were further assessed in patients undergoing LC resection. The diagnostic performance of PTX-3 for LC and early-stage LC was assessed using receiver operating characteristics (ROC) by comparing with serum carcinoembryonic antigen (CEA), cytokeratin 19 fragments (CYFRA 21-1).
Levels of PTX-3 in serum were significantly higher in patients with LC than all controls. ROC curves showed the optimum diagnostic cutoff was 8.03ng/mL (AUC 0.823, [95%CI 0.789-0.856], sensitivity 72.8%, and specificity 77.3% in the test cohort; 0.802, [95%CI 0.762-0.843], sensitivity 69.7%, and specificity 76.4% in the validate cohort). Similar diagnostic performance of PTX-3 was observed for early-stage LC. PTX-3 decreased following surgical resection of LC and increased with tumor recurrence. Significantly elevated PTX-3 levels were also seen in patients with non-lung cancers.
The present data revealed that PTX-3 was significantly increased in both tissue and serum samples in LC patients. PTX-3 is a valuable biomarker for LC and improved identification of patients with LC and early-stage LC from those with non-malignant lung diseases.
肺癌在全球范围内普遍存在,需要改进及时有效的诊断方法。作为一种新型肺癌血清标志物的五聚体-3在大型队列研究中尚未得到验证。本研究的目的是评估其在诊断和预后方面的临床价值。
我们分析了总共1605例肺癌患者、良性肺部疾病患者和健康对照者以及493例非肺癌患者(包括12种不同类型的癌症)的血清PTX-3水平。对接受肺癌切除术的患者进一步评估术前和术后数据。通过与血清癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA 21-1)比较,使用受试者工作特征曲线(ROC)评估PTX-3对肺癌和早期肺癌的诊断性能。
肺癌患者血清中PTX-3水平显著高于所有对照组。ROC曲线显示最佳诊断临界值为8.03ng/mL(测试队列中AUC为0.823,[95%CI 0.789-0.856],敏感性72.8%,特异性77.3%;验证队列中AUC为0.802,[95%CI 0.762-0.843],敏感性69.7%,特异性76.4%)。对于早期肺癌,观察到PTX-3具有相似的诊断性能。肺癌手术切除后PTX-3下降,肿瘤复发时升高。非肺癌患者中PTX-3水平也显著升高。
目前的数据显示,肺癌患者的组织和血清样本中PTX-3均显著升高。PTX-3是一种有价值的肺癌生物标志物,有助于从非恶性肺部疾病患者中更好地识别肺癌患者和早期肺癌患者。