Hataysal Esra Paydas, Kanat Fikret, Korez Muslu Kazim, Yilmaz Farise, Unlu Ali, Vatansev Husamettin
Department of Biochemistry, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkiye.
Department of Chest Diseases, Selcuk University Faculty of Medicine, Konya, Turkiye.
North Clin Istanb. 2025 Jan 29;12(1):45-54. doi: 10.14744/nci.2024.38991. eCollection 2025.
Lung cancer is one of the most prevalent malignancies worldwide, with 80-85% of cases diagnosed as non-small cell lung cancer (NSCLC). The majority of NSCLC patients present with advanced disease, contributing to high mortality and limited treatment options. Angiogenesis, a crucial process in cancer progression, is largely regulated by growth factors and cytokines. Vascular Endothelial Growth Factor (VEGF) is a key regulator of angiogenesis. Asymmetric Dimethyl Arginine (ADMA) inhibits endothelial nitric oxide synthase (eNOS), leading to reduced nitric oxide (NO) release and subsequent endothelial dysfunction. The aim of this study is to investigate the serum levels of ADMA, NO, VEGF and several tumor markers including Carcinoembryonic Antigen (CEA), Cancer Antigen 125 (CA 125), Neuron Specific Enolase (NSE), Lactate dehydrogenase (LDH) and Cyfra 21-1 in NSCLC patients to assess their potential role in early diagnosis, tumor invasion, and staging of the disease.
Our study consisted of 56 newly diagnosed NSCLC patients and 32 controls with similar demographic characteristics. Patients with chronic diseases and inflammatory disorders were excluded. Statistical analysis was conducted using R Statistical Software.
In our study, compared to the control group, the serum VEGF, NO, ADMA, CA 125, CEA, Cyfra 21-1 and NSE levels were significantly higher in NSCLC group (p=0.001, p=0.013, p=0.041, p<0.001, p<0.001, p<0.001 and p=0.001, respectively). In the diagnosis of NSCLC, Cyfra 21-1 exhibited the highest diagnostic efficacy with a 71% sensitivity and 94% specificity. The combination of VEGF, CA125, and Cyfra 21-1 showed a 73% sensitivity and 100% specificity, while the combination of CA125, CEA, and Cyfra 21-1 achieved an 85% sensitivity and 91% specificity.
Our study revealed that the serum concentrations of VEGF, NO, ADMA, CA125, Cyfra 21-1, CEA, and NSE were significantly elevated in patients with NSCLC compared to the control group, and that levels of Cyfra 21-1, LDH, and NSE increased with advancing TNM stage. The combination of markers distinguished NSCLC with high sensitivity and specificity. Further studies involving larger populations, including those with benign lung diseases, are needed to validate and expand upon our findings.
肺癌是全球最常见的恶性肿瘤之一，80 - 85%的病例被诊断为非小细胞肺癌（NSCLC）。大多数NSCLC患者就诊时已处于晚期，导致死亡率高且治疗选择有限。血管生成是癌症进展中的一个关键过程，主要受生长因子和细胞因子调控。血管内皮生长因子（VEGF）是血管生成的关键调节因子。不对称二甲基精氨酸（ADMA）抑制内皮型一氧化氮合酶（eNOS），导致一氧化氮（NO）释放减少及随后的内皮功能障碍。本研究旨在调查NSCLC患者血清中ADMA、NO、VEGF以及几种肿瘤标志物（包括癌胚抗原（CEA）、癌抗原125（CA 125）、神经元特异性烯醇化酶（NSE）、乳酸脱氢酶（LDH）和细胞角蛋白19片段（Cyfra 21-1））的水平，以评估它们在疾病早期诊断、肿瘤侵袭和分期中的潜在作用。
我们的研究包括56例新诊断的NSCLC患者和32例具有相似人口统计学特征的对照组。排除患有慢性疾病和炎症性疾病的患者。使用R统计软件进行统计分析。
在我们的研究中，与对照组相比，NSCLC组血清VEGF、NO、ADMA、CA 125、CEA、Cyfra 21-1和NSE水平显著更高（分别为p = 0.001、p = 0.013、p = 0.041、p < 0.001、p < 0.001、p < 0.001和p = 0.001）。在NSCLC诊断中，Cyfra 21-1表现出最高的诊断效能，敏感性为71%，特异性为94%。VEGF、CA125和Cyfra 21-1的联合检测敏感性为73%，特异性为100%，而CA125、CEA和Cyfra 21-1的联合检测敏感性为85%，特异性为91%。
我们的研究表明，与对照组相比，NSCLC患者血清中VEGF、NO、ADMA、CA125、Cyfra 21-1、CEA和NSE的浓度显著升高，且Cyfra 21-1、LDH和NSE的水平随TNM分期进展而升高。标志物联合检测以高敏感性和特异性区分NSCLC。需要进一步开展涉及更大人群（包括良性肺病患者）的研究来验证和扩展我们的发现。
