Department of Pulmonology, Gazi University, Ankara.
Department of Pulmonology, Yıldırım Beyazıt University, Ankara.
Monaldi Arch Chest Dis. 2022 Nov 14;93(3). doi: 10.4081/monaldi.2022.2373.
Progranulin has been considered to be a poor prognostic biomarker for some types of malignancies. However, the clinical significance of serum progranulin level and the prognostic value are still not explored in advanced stages of lung cancer. The current study investigates the prognostic significance of progranulin serum levels in advanced-stage non-small cell lung cancer (NSCLC) patients. This study involved 94 subjects (70 advanced-stage NSCLC patients and 24 healthy controls). Serum progranulin level was measured by enzyme-linked immunosorbent assay (ELISA) and was correlated with patient outcome. The association between circulating progranulin level and clinicopathological parameters was detected. Serum progranulin cut-off level predicting six-month survival was determined. Serum progranulin level was found significantly elevated in NSCLC patients than in the control group (p<0.001). We did not determine a significant difference between stage IIIB and stage IV NSCLC patients for serum progranulin levels (p=0.166). When we evaluated the laboratory parameters, only serum LDH level was found significantly correlated with serum progranulin level (p=0.043), also bone and liver metastasis showed a significant correlation with progranulin level (p=0.008 and p = 0.024, respectively). The cut-off level of serum progranulin in predicting six months of survival was determined as 16.03 ng/ml (AUC = 0.973, 95%Cl: 0.903-0.997, p<0.001) with 97.06% sensitivity and 88.89% specificity. Overall survival was determined shorter in patients with progranulin level ≥16 ng/ml than those with <16 ng/ml (p<0.001). Also, in the multivariate analysis using the Cox regression model serum progranulin level was found as an independent prognostic factor for NSCLC (p=0.001). Serum progranulin level may be a useful biomarker for predicting poor survival in advanced-stage NSCLC patients.
颗粒蛋白前体被认为是某些类型恶性肿瘤的预后不良生物标志物。然而，在晚期肺癌中，血清颗粒蛋白前体水平的临床意义和预后价值仍未得到探索。本研究调查了晚期非小细胞肺癌（NSCLC）患者血清颗粒蛋白前体水平的预后意义。该研究纳入了 94 名受试者（70 名晚期 NSCLC 患者和 24 名健康对照者）。通过酶联免疫吸附试验（ELISA）测量血清颗粒蛋白前体水平，并与患者预后相关联。检测了循环颗粒蛋白前体水平与临床病理参数之间的关系。确定了预测 6 个月生存率的血清颗粒蛋白前体截断值。结果发现，与对照组相比，NSCLC 患者的血清颗粒蛋白前体水平显著升高（p<0.001）。但在 IIIB 期和 IV 期 NSCLC 患者之间，我们没有发现血清颗粒蛋白前体水平有显著差异（p=0.166）。当我们评估实验室参数时，只有血清乳酸脱氢酶（LDH）水平与血清颗粒蛋白前体水平显著相关（p=0.043），骨转移和肝转移与颗粒蛋白前体水平也显著相关（p=0.008 和 p=0.024）。预测 6 个月生存率的血清颗粒蛋白前体截断值为 16.03ng/ml（AUC=0.973，95%Cl：0.903-0.997，p<0.001），灵敏度为 97.06%，特异性为 88.89%。颗粒蛋白前体水平≥16ng/ml 的患者的总生存时间明显短于颗粒蛋白前体水平<16ng/ml 的患者（p<0.001）。此外，在使用 Cox 回归模型的多变量分析中，血清颗粒蛋白前体水平被发现是非小细胞肺癌的独立预后因素（p=0.001）。血清颗粒蛋白前体水平可能是预测晚期 NSCLC 患者不良生存的有用生物标志物。
