Serum biomarker profiles as diagnostic tools in lung cancer

Abstract

Background Computed tomography (CT) scanning has emerged as an effective means of early detection for lung cancer. Despite marked improvement over earlier methodologies, the low level of specificity demonstrated by CT scanning has limited its clinical implementation as a screening tool. A minimally-invasive biomarker-based test that could further characterize CT-positive patients based on risk of malignancy would greatly enhance its clinical efficacy. Methods We performed an analysis of 81 serum proteins in 92 patients diagnosed with lung cancer and 172 CT-screened control individuals. We utilize a series of bioinformatics algorithms including Metropolis-Monte Carlo, artificial neural networks, Naïve Bayes, and additive logistic regression to identify multimarker panels capable of discriminating cases from controls with high levels of sensitivity and specificity in distinct training and independent validation sets. Results A three-biomarker panel comprised of MIF, prolactin, and thrombospondin identified using the Metropolis-Monte Carlo algorithm provided the best classification with a %Sensitivity/Specificity/Accuracy of 74/90/86 in the training set and 70/93/82 in the validation set. This panel was effective in the classification of control individuals demonstrating suspicious pulmonary nodules and stage I lung cancer patients. Conclusions The selected serum biomarker panel demonstrated a high diagnostic utility in the current study and performance characteristics which compare favorably with previous reports. Further advancements may lead to the development of a diagnostic tool useful as an adjunct to CT-scanning.

Urinary Protein Biomarkers in the Early Detection of Lung Cancer

“…Our group previously reported on the use of serum biomarkers as screening tools for NSCLC in a similarly designed study (41), and a comparison of this and the current studies provides several noteworthy observations. MIF was an essential component of the top biomarker panels in the previous serum study, however although it was found to be significantly altered, it was not included in the top performing panels in the current study.…”

“…The performance of this panel also exceeds that of our recently reported serum biomarker panel consisting of MIF, prolactin and thrombospondin which provided a SN/SP of 74/90 in a study of 164 NSCLC patients and healthy controls (41). The evaluation of candidate biomarker panels in early stage cancer patients is likely the most critical aspect in panel development, given the potential to produce a stage shift among cancer diagnoses and improvements in survival trends.…”

Identification of Serum Monocyte Chemoattractant Protein-1 and Prolactin as Potential Tumor Markers in Hepatocellular Carcinoma

“…Elevation of serum prolactin, on the other hand, had also been observed in other malignancies and explored for their potential as diagnostic biomarkers, such as in lung and ovarian cancers [47]–[51]. However, although shown to be potentially useful as a member of multi-marker diagnostic panels, none of these studies could establish prolactin as an independent cancer marker.…”

Proteomic profiling of human plasma identifies apolipoprotein E as being associated with smoking and a marker for squamous metaplasia of the lung

“…Identification of these proteins not only provides information in understanding the mechanisms that can account for lung cancer development, but also in providing biomarkers to monitor disease progression [16]. Most of the potential markers described in the literature are derived from end-stage tumors and thus, no biomarkers have achieved sufficient diagnostic significance to reach clinical applications for early diagnosis of lung cancer with an impact on mortality [11,17,18].…”