Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Functional RNomics Research Center, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Cancer Med. 2019 Sep;8(12):5507-5514. doi: 10.1002/cam4.2457. Epub 2019 Aug 3.
Early detection of cancer provides effective treatment and saves lives. The objective of this study was to determine whether serum gastrokine 1 (GKN1) protein is a gastric cancer-specific diagnostic biomarker. The serum concentration of GKN1 in healthy individuals (median: 6.34 ng/μL, interquartile range (IQR): 5.66-7.54 ng/μL) was significantly higher compared with the levels in gastric cancer patients (median: 3.48 ng/μL, IQR: 2.90-4.11 ng/μL; P < .0001). At the optimum cutoff (4.94 ng/μL) of serum GKN1 protein, the sensitivity and specificity were 91.2% and 96.0%, respectively, for gastric cancer. Using serum GKN1 protein as the diagnostic reference, the ROC curve showed a satisfactory diagnostic efficacy with an AUC value of 0.9954 (95% CI 0.9919-0.9988) and Youden index of 0.8740. In addition, the diagnostic accuracy of the serum GKN1 protein at the optimum cutoff was 0.9675. Interestingly, serum GKN1 concentrations in patients with advanced gastric cancer (AGC; median: 3.11 ng/μL, IQR: 2.72-3.72 ng/μL) were lower than in patients with early gastric cancer (EGC; median: 4.31 ng/μL, IQR: 3.88-4.88 ng/μL). The diagnostic accuracies at the optimum serum GKN1 cutoff were 0.8912 and 0.9589 for EGC and AGC, respectively. Furthermore, the serum GKN1 concentrations robustly discriminated the patients with gastric cancer from the patients with colorectal, liver, lung, breast, pancreatic, ovary, and prostatic cancers with AUC values greater than 0.94. These data suggest that serum GKN1 is a promising and highly specific diagnostic biomarker for the prompt detection of early and advanced gastric cancers.
早期发现癌症可提供有效的治疗并挽救生命。本研究旨在确定血清胃泌素 1（GKN1）蛋白是否为胃癌特异性诊断生物标志物。健康个体血清 GKN1 浓度（中位数：6.34ng/μL，四分位距（IQR）：5.66-7.54ng/μL）明显高于胃癌患者（中位数：3.48ng/μL，IQR：2.90-4.11ng/μL；P<0.0001）。在血清 GKN1 蛋白最佳截断值（4.94ng/μL）时，对胃癌的灵敏度和特异性分别为 91.2%和 96.0%。以血清 GKN1 蛋白为诊断参考，ROC 曲线显示出令人满意的诊断效能，AUC 值为 0.9954（95%CI 0.9919-0.9988），Youden 指数为 0.8740。此外，最佳截断值下血清 GKN1 蛋白的诊断准确率为 0.9675。有趣的是，晚期胃癌（AGC；中位数：3.11ng/μL，IQR：2.72-3.72ng/μL）患者血清 GKN1 浓度低于早期胃癌（EGC；中位数：4.31ng/μL，IQR：3.88-4.88ng/μL）。在最佳血清 GKN1 截断值时，EGC 和 AGC 的诊断准确率分别为 0.8912 和 0.9589。此外，血清 GKN1 浓度可很好地区分胃癌患者与结直肠癌、肝癌、肺癌、乳腺癌、胰腺癌、卵巢癌和前列腺癌患者，AUC 值大于 0.94。这些数据表明，血清 GKN1 是一种很有前途的高度特异性诊断生物标志物，可用于早期和晚期胃癌的快速检测。
