Serum calprotectin, CD26 and EGF to establish a panel for the diagnosis of lung cancer

PLoS One. 2015 May 18;10(5):e0127318. doi: 10.1371/journal.pone.0127318. eCollection 2015.

Abstract

Lung cancer is the most lethal neoplasia, and an early diagnosis is the best way for improving survival. Symptomatic patients attending Pulmonary Services could be diagnosed with lung cancer earlier if high-risk individuals are promptly separated from healthy individuals and patients with benign respiratory pathologies. We searched for a convenient non-invasive serum test to define which patients should have more immediate clinical tests. Six cancer-associated molecules (HB-EGF, EGF, EGFR, sCD26, VEGF, and Calprotectin) were investigated in this study. Markers were measured in serum by specific ELISAs, in an unselected population that included 72 lung cancer patients of different histological types and 56 control subjects (healthy individuals and patients with benign pulmonary pathologies). Boosted regression and random forests analysis were conducted for the selection of the best candidate biomarkers. A remarkable discriminatory capacity was observed for EGF, sCD26, and especially for Calprotectin, these three molecules constituting a marker panel boasting a sensitivity of 83% and specificity of 87%, resulting in an associated misclassification rate of 15%. Finally, an algorithm derived by logistic regression and a nomogram allowed generating classification scores in terms of the risk of a patient of suffering lung cancer. In conclusion, we propose a non-invasive test to identify patients at high-risk for lung cancer from a non-selected population attending a Pulmonary Service. The efficacy of this three-marker panel must be tested in a larger population for lung cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms
  • Biomarkers, Tumor / blood*
  • Carcinoma, Non-Small-Cell Lung / blood
  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Dipeptidyl Peptidase 4 / blood
  • Early Detection of Cancer / methods*
  • Epidermal Growth Factor / blood
  • Female
  • Humans
  • Leukocyte L1 Antigen Complex / blood
  • Logistic Models
  • Lung Neoplasms / blood
  • Lung Neoplasms / diagnosis*
  • Male
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity

Substances

  • Biomarkers, Tumor
  • Leukocyte L1 Antigen Complex
  • Epidermal Growth Factor
  • DPP4 protein, human
  • Dipeptidyl Peptidase 4

Grants and funding

This research was supported by project PS09-00405 from Instituto de Salud Carlos III, Grouping of Inbiomed 2012/273, and funding from FEDER DXPCTSUG-Feder (CN 2011/024). S. Blanco-Prieto was supported by a fellowship from the Programa Nacional de Formación de Profesorado Universitario (FPU, Spanish Ministry of Science and Innovation). M. Rodríguez-Girondo acknowledges financial support of Grant MTM2011-23204 (FEDER support included) of the Spanish Ministry of Science and Innovation and INBIOMED 2009-063 of the Xunta de Galicia. The samples used in this work belong to the Biobank from the CHUVI (RETIC-FIS-ISCIII RD09/0076/00011).