高危人群中循环生物标志物检测肺癌的评估。

Assessment of circulating biomarkers for detection of lung cancer in a high-risk cohort.

机构信息

Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark.

Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

出版信息

Cancer Biomark. 2023;36(1):63-69. doi: 10.3233/CBM-210543.

DOI:10.3233/CBM-210543

PMID:36404535

Abstract

BACKGROUND

There is an urgent need for early detection of lung cancer. Screening with low-dose computed tomography (LDCT) is now implemented in the US. Supplementary use of a lung cancer biomarker with high specificity is desirable.

OBJECTIVE

To assess the diagnostic properties of a biomarker panel consisting of cytokeratin 19 fragment (CYFRA 21-1), carcinoembryonic antigen (CEA) and cancer antigen 125 (CA125).

METHODS

A cohort of 250 high-risk patients was investigated on suspicion of lung cancer. Ahead of diagnostic work-up, blood samples taken. Cross-validated prediction models were computed to assess lung cancer detection properties.

RESULTS

In total 32% (79/250) of patients were diagnosed with lung cancer. Area under the curve (AUC) for the three biomarkers was of 0.795, with sensitivity/specificity of 57%/93% and negative predictive value of 83%. When combining the biomarkers with US screening criteria, the AUC was 0.809, while applying only US screening criteria on the cohort, yielded an AUC of 0.62. The ability of the biomarkers to detect stage I-II lung cancer was substantially lower; AUC 0.54.

CONCLUSIONS

In a high-risk cohort, the detection properties of the three biomarkers were acceptable compared to current LDCT screening criteria. However, the ability to detect early stage lung cancer was low.

摘要

背景

迫切需要早期发现肺癌。目前在美国已经实施了低剂量计算机断层扫描（LDCT）筛查。期望使用具有高特异性的肺癌生物标志物进行补充检测。

目的

评估由细胞角蛋白 19 片段（CYFRA 21-1）、癌胚抗原（CEA）和癌抗原 125（CA125）组成的生物标志物组合的诊断性能。

方法

对 250 名疑似患有肺癌的高危患者进行了研究。在进行诊断性检查之前，采集了血样。计算了交叉验证预测模型，以评估肺癌检测性能。

结果

共有 32%（79/250）的患者被诊断为肺癌。三种生物标志物的曲线下面积（AUC）为 0.795，敏感性/特异性为 57%/93%，阴性预测值为 83%。当将生物标志物与 US 筛查标准结合使用时，AUC 为 0.809，而仅对该队列应用 US 筛查标准时，AUC 为 0.62。生物标志物检测 I 期-II 期肺癌的能力明显较低；AUC 为 0.54。