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J Cancer 2021; 12(10):2835-2843. doi:10.7150/jca.57429 This issue Cite

Research Paper

Auxiliary diagnosis of Lung Cancer on the basis of a Serum Protein Biomarker Panel

Qiong Lu^1*, Zhongwei Jia^1*, Junli Gao², Meijuan Zheng¹, Junshun Gao², Mingjie Tong², Jinxing Xia¹, Fang Li², Baoling Yang², Lili Zhang², Bo Wang¹, Rui Wang², Jinping Qiao¹, Qinqin Lou², Jinbo Gao^2✉, Yuanhong Xu^1✉

1. Department of Clinical Laboratory, the First Affiliated Hospital of Anhui Medical University, Hefei, 230031, China.
2. Cosmos Wisdom Mass Spectrometry Center of Zhejiang University Medical School, Hangzhou, 311200, China.
*These authors contributed equally to this article.

✉ Corresponding authors: Jinbo Gao & Yuanhong Xu contributed equally to this work. Jinbo Gao, Ph.D., Cosmos Wisdom Mass Spectrometry Center of Zhejiang University Medical School, 5th Floor, Block D, 198 Qidi Road, Xiao Shan Economic & Technological Development Zone, Hangzhou, Zhejiang Province, 311200, China; E-mail: ghy0510edu.cn; and Yuanhong Xu, Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui Province, 230031, China; E-mail: xyhong1964edu.cn. More

Abstract

Objectives: In this study, we established a serum protein biomarker panel (consisting of Pro-SFTPB, CA125, Cyfra21-1, and CEA) and evaluated the feasibility and performance for the auxiliary diagnosis of lung cancer in the Chinese population.

Materials and Methods: The current study was a single-center study based on the Chinese population and performed in two cohorts (training cohort and validation cohort). Serum concentrations of Pro-SFTPB, CA125, Cyfra21-1, and CEA were measured by a bead-based flow fluorescence immunoassay. The discrimination performance of the model was assessed using sensitivity, specificity, and the area under the receiver operating characteristic (ROC) curve (AUC).

Results: For the biomarker panel model, the AUC was 0.88 (95% CI, 0.85-0.91) in the training cohort and 0.90 (95% CI, 0.86-0.92) in the validation data cohort, which was significantly greater than the AUC of each biomarker alone. For the nodule risk model, the AUC was improved to 0.96 (95% CI, 0.94-0.98) in the training cohort and 0.95 (95% CI, 0.93-0.97) in the validation cohort. In addition, the biomarker panel model yielded an AUC of 0.78 (95% CI, 0.74-0.81) for stage I & II lung cancer, better than the performance of individual biomarker alone.

Conclusions: It was demonstrated that 4-protein biomarker panel had a significant performance in identifying lung cancer patients from healthy controls, especially combining with the nodule size. Specifically, it yielded excellent discrimination for identifying early-stage lung cancer patients than individual biomarker alone. A future large-scale study is underway to further define the clinical application of this method for the early diagnosis of lung cancer among Chinese populations.

Keywords: lung cancer, protein biomarker, nodule, cancer diagnosis, Chinese populations

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