Lack of Efficacy of Combined Carbohydrate Antigen Markers for Lung Cancer Diagnosis
Background. Lung cancer (LC) is top-ranked in cancer incidence and is the leading cause of cancer death globally. Combining serum biomarkers can improve the accuracy of LC diagnosis. The identification of the best potential combination of traditional tumor markers is essential for LC diagnosis. Pati...
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doaj-4f9ad15dc37d4fe4b0f395e5286febf42020-12-21T11:41:26ZengHindawi LimitedDisease Markers0278-02401875-86302020-01-01202010.1155/2020/47167934716793Lack of Efficacy of Combined Carbohydrate Antigen Markers for Lung Cancer DiagnosisZhineng Wen0Ying Huang1Zhougui Ling2Jifei Chen3Xiaomou Wei4Rui Su5Zhenming Tang6Zhongwei Wen7Youping Deng8Zhuojun Hu9Department of Pulmonary and Critical Care Medicine, The Fourth Affiliated Hospital of Guangxi Medical University, No. 1, Liushi Road, Liuzhou 545000, ChinaDepartment of Pulmonary and Critical Care Medicine, The Fourth Affiliated Hospital of Guangxi Medical University, No. 1, Liushi Road, Liuzhou 545000, ChinaDepartment of Pulmonary and Critical Care Medicine, The Fourth Affiliated Hospital of Guangxi Medical University, No. 1, Liushi Road, Liuzhou 545000, ChinaClinical Laboratory, The Fourth Affiliated Hospital of Guangxi Medical University, No. 1, Liushi Road, Liuzhou 545000, ChinaClinical Laboratory, The Fourth Affiliated Hospital of Guangxi Medical University, No. 1, Liushi Road, Liuzhou 545000, ChinaDepartment of Pulmonary and Critical Care Medicine, The Fourth Affiliated Hospital of Guangxi Medical University, No. 1, Liushi Road, Liuzhou 545000, ChinaDepartment of Pulmonary and Critical Care Medicine, The Fourth Affiliated Hospital of Guangxi Medical University, No. 1, Liushi Road, Liuzhou 545000, ChinaDepartment of Pulmonary and Critical Care Medicine, The Fourth Affiliated Hospital of Guangxi Medical University, No. 1, Liushi Road, Liuzhou 545000, ChinaDepartment of Quantitative Health Sciences, University of Hawaii John A. Burns School of Medicine, Honolulu, HI 96813, USADepartment of Pulmonary and Critical Care Medicine, The Fourth Affiliated Hospital of Guangxi Medical University, No. 1, Liushi Road, Liuzhou 545000, ChinaBackground. Lung cancer (LC) is top-ranked in cancer incidence and is the leading cause of cancer death globally. Combining serum biomarkers can improve the accuracy of LC diagnosis. The identification of the best potential combination of traditional tumor markers is essential for LC diagnosis. Patients and Methods. Blood samples were collected from 132 LC cases and 118 benign lung disease (BLD) controls. The expression levels of ten serum tumor markers (CYFR21, CEA, NSE, SCC, CA15-3, CA 19-9, CA 125, CA50, CA242, and CA724) were assayed, and that the expression in the levels of tumor markers were evaluated, isolated, and combined in different patients. The performance of the biomarkers was analyzed by receiver operating characteristic (ROC) analyses, and the difference between combinations of biomarkers was compared by Chi-square (χ2) tests. Results. As single markers, CYFR21 and CEA showed good diagnostic efficacy for nonsmall cell lung cancer (NSCLC) patients, while NSE and CEA were the most sensitive in the diagnosis of small cell lung cancer (SCLC). The area under the curve (AUC) value was 0.854 for the panel of four biomarkers (CYFR21, CEA, NSE, and SCC), 0.875 for the panel of six biomarkers (CYFR21, CEA, NSE, SCC, CA125, and CA15-3), and 0.884 for the panel of ten markers (CYFR21, CEA, NSE, SCC, CA125, CA15-3, CA19-9, CA50, CA242, and CA724). With a higher sensitivity and negative predictive value (NPV), the diagnostic accuracy of the three panels was better than that of any single biomarker, but there were no statistically significant differences among them (all P values > 0.05). However, the panel of six carbohydrate antigen (CA) biomarkers (CA125, CA15-3, CA19-9, CA50, CA242, and CA724) showed a lower diagnostic value (AUC: 0.776, sensitivity: 59.8%, specificity: 73.0%, and NPV: 60.4%) than the three panels (P value < 0.05). The performance was similar even when analyzed individually by LC subtypes. Conclusion. The biomarkers isolated are elevated for different types of lung cancer, and the panel of CYFR21, CEA, NSE, and SCC seems to be a promising serum biomarker for the diagnosis of lung cancer, while the combination with carbohydrate antigen markers does not improve the diagnostic efficacy.http://dx.doi.org/10.1155/2020/4716793 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zhineng Wen Ying Huang Zhougui Ling Jifei Chen Xiaomou Wei Rui Su Zhenming Tang Zhongwei Wen Youping Deng Zhuojun Hu |
spellingShingle |
Zhineng Wen Ying Huang Zhougui Ling Jifei Chen Xiaomou Wei Rui Su Zhenming Tang Zhongwei Wen Youping Deng Zhuojun Hu Lack of Efficacy of Combined Carbohydrate Antigen Markers for Lung Cancer Diagnosis Disease Markers |
author_facet |
Zhineng Wen Ying Huang Zhougui Ling Jifei Chen Xiaomou Wei Rui Su Zhenming Tang Zhongwei Wen Youping Deng Zhuojun Hu |
author_sort |
Zhineng Wen |
title |
Lack of Efficacy of Combined Carbohydrate Antigen Markers for Lung Cancer Diagnosis |
title_short |
Lack of Efficacy of Combined Carbohydrate Antigen Markers for Lung Cancer Diagnosis |
title_full |
Lack of Efficacy of Combined Carbohydrate Antigen Markers for Lung Cancer Diagnosis |
title_fullStr |
Lack of Efficacy of Combined Carbohydrate Antigen Markers for Lung Cancer Diagnosis |
title_full_unstemmed |
Lack of Efficacy of Combined Carbohydrate Antigen Markers for Lung Cancer Diagnosis |
title_sort |
lack of efficacy of combined carbohydrate antigen markers for lung cancer diagnosis |
publisher |
Hindawi Limited |
series |
Disease Markers |
issn |
0278-0240 1875-8630 |
publishDate |
2020-01-01 |
description |
Background. Lung cancer (LC) is top-ranked in cancer incidence and is the leading cause of cancer death globally. Combining serum biomarkers can improve the accuracy of LC diagnosis. The identification of the best potential combination of traditional tumor markers is essential for LC diagnosis. Patients and Methods. Blood samples were collected from 132 LC cases and 118 benign lung disease (BLD) controls. The expression levels of ten serum tumor markers (CYFR21, CEA, NSE, SCC, CA15-3, CA 19-9, CA 125, CA50, CA242, and CA724) were assayed, and that the expression in the levels of tumor markers were evaluated, isolated, and combined in different patients. The performance of the biomarkers was analyzed by receiver operating characteristic (ROC) analyses, and the difference between combinations of biomarkers was compared by Chi-square (χ2) tests. Results. As single markers, CYFR21 and CEA showed good diagnostic efficacy for nonsmall cell lung cancer (NSCLC) patients, while NSE and CEA were the most sensitive in the diagnosis of small cell lung cancer (SCLC). The area under the curve (AUC) value was 0.854 for the panel of four biomarkers (CYFR21, CEA, NSE, and SCC), 0.875 for the panel of six biomarkers (CYFR21, CEA, NSE, SCC, CA125, and CA15-3), and 0.884 for the panel of ten markers (CYFR21, CEA, NSE, SCC, CA125, CA15-3, CA19-9, CA50, CA242, and CA724). With a higher sensitivity and negative predictive value (NPV), the diagnostic accuracy of the three panels was better than that of any single biomarker, but there were no statistically significant differences among them (all P values > 0.05). However, the panel of six carbohydrate antigen (CA) biomarkers (CA125, CA15-3, CA19-9, CA50, CA242, and CA724) showed a lower diagnostic value (AUC: 0.776, sensitivity: 59.8%, specificity: 73.0%, and NPV: 60.4%) than the three panels (P value < 0.05). The performance was similar even when analyzed individually by LC subtypes. Conclusion. The biomarkers isolated are elevated for different types of lung cancer, and the panel of CYFR21, CEA, NSE, and SCC seems to be a promising serum biomarker for the diagnosis of lung cancer, while the combination with carbohydrate antigen markers does not improve the diagnostic efficacy. |
url |
http://dx.doi.org/10.1155/2020/4716793 |
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