Open AccessSerum Cripto‐1 is a novel biomarker for non‐small cell lung cancer diagnosis and prognosis
Author(s) -
Xu Chun Hua,
Wang Yan,
Qian Li Hua,
Yu Li Ke,
Zhang Xiu Wei,
Wang Qing Bo
Publication year - 2017
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12414
Subject(s) - medicine , carcinoembryonic antigen , lung cancer , hazard ratio , gastroenterology , stage (stratigraphy) , biomarker , oncology , clinical significance , lung , proportional hazards model , cancer , pathology , confidence interval , paleontology , biochemistry , chemistry , biology
Abstract Introduction Cripto‐1 (CR‐1) is highly expressed in several different types of human tumors. However, the clinical significance of CR‐1 expression in serum specimens from non‐small cell lung cancer (NSCLC) patients has not yet been determined. Objectives The aim of this study was to explore the diagnostic and prognostic value of serum CR‐1 levels in patients with NSCLC. Methods Serum specimens from 592 NSCLC patients, 180 benign lung disease patients and 240 healthy controls were collected. The concentrations of CR‐1 were measured by sandwich enzyme‐linked immunosorbent assay. Results Patients with NSCLC had higher serum CR‐1 levels than the controls ( P < 0.01) and patients with benign lung diseases ( P < 0.01). When a cutoff point of 1.8 ng/mL was selected (diagnostic specificity 95%), the diagnostic sensitivity for NSCLC is 56.8%. About 37.5% of carcinoembryonic antigen (CEA)‐negative lung cancer patients were CR‐1 positive at 95% specificity. In patients with stage I/II lung cancer, use of these two markers in combination results in almost 21% increase in sensitivity, at 95% specificity, compared with CEA alone. Uni‐variate analysis revealed that NSCLC patients with positive CR‐1 had a shorter overall survival (OS) and progression‐free survival (PFS) than those with negative CR‐1 [hazard ratio (HR) of 2.93, P = 0.005; HR of 2.12, P = 0.005]. Cox multi‐variate analysis indicated that CR‐1 was an independent prognostic indicator of PFS and OS (HR of 1.91, P = 0.006; HR of 1.82, P = 0.007). Kaplan–Meier survival curves further confirmed that patients with negative CR‐1 had longer PFS and OS ( P = 0.026 and P = 0.011, respectively). Conclusions In conclusion, measurement of serum CR‐1 is a useful diagnostic and prognostic marker for NSCLC patients.