The diagnostic value of apolipoprotein E in malignant pleural effusion associated with non-small cell lung cancer

Wang, Yumin; Chen, Zengqiang; Chen, Jie; Pan, Jingye; Zhang, Wenhui; Pan, Qinshi; Ding, Haiyan; Lin, Xiao; Wen, Xiaohong; Li, Yangyang; Meng, Qing H.

doi:10.1016/j.cca.2013.03.013

Cited by 27 publications

(20 citation statements)

References 18 publications

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“…However, there were no significant differences between pleural fluid CRP levels in the MPE and NSPE groups, so CRP did not demonstrate any diagnostic value for patients with MPE and NSPE. Similar independent associations have been revealed by previous studies evaluating the role of pleural fluid CRP (15,17,19); the highest pleural fluid CRP levels were observed in patients with PNPE. However, the findings of the present study conflict with the observations of Botana-Rial et al (14), who found no correlation between CRP values in TBPE and MPE patients.…”

Section: Discussionsupporting

confidence: 89%

“…However, pleural fluid cytology is positive in only 50% of cases, leading to the requirement for further diagnostic tests (16). In clinical practice a variety of laboratory tests are in use for the differential diagnosis of PE; nevertheless, the efficiency of these measurements is not always sufficient to establish a diagnosis (1,17). Thus, the requirement for biomarkers that may aid in this differentiation is imperative.…”

Section: Introductionmentioning

confidence: 99%

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Pleural fluid prealbumin and C-reactive protein in the differential diagnosis of infectious and malignant pleural effusions

Huang

Wang

et al. 2014

Experimental and Therapeutic Medicine

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Clinical history and physical examination are helpful in indicating the potential causes of pleural effusions (PEs). However, the accurate diagnosis and establishment of the causes of PE is an ongoing challenge in daily clinical practice. The primary aim of this study was to distinguish between infectious PE and malignant PE (MPE) by measuring two major acute phase response biomarkers: prealbumin (PA) and C-reactive protein (CRP). The study was a prospective trial involving 151 patients who were diagnosed with infectious PE or MPE. Patients with infectious PE were divided into two subgroups: tuberculous PE (TBPE) and parapneumonic PE (PNPE). A further 58 patients with PEs that showed no evidence of MPE, TBPE or PNPE were classified as the chronic non-specific PE (NSPE) group. Demographic characteristics and pleural fluids of the subjects were collected consecutively. The discriminative properties of pleural fluid routine biochemistries, and PA and CRP were evaluated. PA, CRP and classical fluid parameters were also applied to classify patients with infectious PE and MPE. Receiver operating characteristics (ROC) analysis established the cutoffs of PA and CRP for discriminating between groups. Pleural fluid PA levels were significantly higher in the MPE group (n=47) than in the infectious PE group (n=104). Pleural fluid CRP levels were significantly higher in the infectious PE group than in the MPE group. Pleural fluid PA levels were identified to be moderately negatively correlated with CRP levels in the MPE group, with a statistically significant correlation coefficient of −0.352. The ROC curve showed that the sensitivity and specificity of PA for the diagnosis of MPE were 0.851 and 0.548, respectively, at the cutoff of 28.3 mg/l. The area under the curve (AUC) was 0.784 (95% CI, 0.707–0.861). Using CRP as a diagnostic parameter resulted in an comparable AUC of 0.810 (95% CI, 0.736–0.885), at the cutoff of 35.2 mg/l. Combinations of PA and CRP resulted in incrementally discriminating values for MPE, with a sensitivity of 0.617 and a specificity of 0.903. The measurement of PA and CRP levels in pleural fluid may be a useful adjunctive test in PE, as a potential differentiator between infectious PE and MPE.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Pleural fluid prealbumin and C-reactive protein in the differential diagnosis of infectious and malignant pleural effusions

Huang

Wang

et al. 2014

Experimental and Therapeutic Medicine

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“…Transfection of a lung adenocarcinoma cell line with small interfering RNAs to knockdown apoE expression increased cis-platinum-mediated reductions in cellular proliferation and impaired cell migration. Similarly, pleural fluid apoE levels were higher in malignant as compared with benign pleural effusions, especially those associated with adenocarcinomas (52). Collectively, these studies suggest a role for apoE in promoting lung cancer, perhaps by enhancing cholesterol transport into tumor cells (50).…”

Section: Apoe and Lung Cancermentioning

confidence: 73%

Emerging Roles of Apolipoprotein E and Apolipoprotein A-I in the Pathogenesis and Treatment of Lung Disease

Yao

Gordon

Figueroa

et al. 2016

Am J Respir Cell Mol Biol

118

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“…The biological mechanism by which APOE is upregulated and how it supports tumor growth is not clear, however, it could be speculated that elevated APOE could provide much needed cholesterol for the actively growing cancer cells [46]. This is evidenced by the fact that APOE is upregulated in various cancers, and has been shown to affect proliferation, migration, and survival in lung cancer [30,31,47]. APOE can also alter cellular sensitivity to chemotherapeutics [31,48].…”

Section: Discussionmentioning

confidence: 99%

“…1C). APOE was selected for further verification because it has been shown to be upregulated in various cancers including lung cancer [30,31]. Additionally, it was among the highest scoring proteins in CS compared to NS and ES, while not changing between NS and ES ( Table 2).…”

Section: Cancer Biomarkers Identified In Plasma From the Itraq Experimentioning

confidence: 99%

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

et al. 2015

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Biomarkers to identify subjects at high-risk for developing lung cancer will revolutionize the disease outlook. Most biomarker studies have focused on patients already diagnosed with lung cancer and in most cases the disease is often advanced and incurable. The objective of this study was to use proteomics to identify a plasma biomarker for early detection of lung lesions that may subsequently be the harbinger for cancer. Plasma samples were obtained from subjects without lung cancer grouped as never, current, or ex-smokers. An iTRAQ-based proteomic analysis was performed on these pooled plasma samples. We identified 31 proteins differentially abundant in current smokers or ex-smokers relative to never smokers. Western blot and ELISA analyses confirmed the iTRAQ results that demonstrated an increase of apolipoprotein E (APOE) in current smokers as compared to both never and ex-smokers. There was a strong and significant correlation of the plasma APOE levels with development of premalignant squamous metaplasia. Additionally, we also showed that higher tissue levels of APOE are seen with squamous metaplasia, supporting a direct relationship. Our analysis reveals that elevated plasma APOE is associated with smoking, and APOE is a novel predictive protein biomarker for early morphological changes of squamous metaplasia in the lung.

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The diagnostic value of apolipoprotein E in malignant pleural effusion associated with non-small cell lung cancer

Cited by 27 publications

References 18 publications

Pleural fluid prealbumin and C-reactive protein in the differential diagnosis of infectious and malignant pleural effusions

Pleural fluid prealbumin and C-reactive protein in the differential diagnosis of infectious and malignant pleural effusions

Emerging Roles of Apolipoprotein E and Apolipoprotein A-I in the Pathogenesis and Treatment of Lung Disease

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

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