BACKGROUNDLung cancer is one of the most common malignancies in the world and one of the leading cancers that result in death. The aim of this study was to evaluate and compare the diagnostic value of the serum tumor marker pro-gastrin-releasing peptide 31-98 (ProGRP31-98) to pathological diagnosis as reference standard in patients with suspected small cell lung cancer (SCLC).

METHODSLiterature searches covering 1978 through to 2009 were performed in Pubmed, OVID, MEDLINE, EMbase, Cancerlit, China National Knowledge Infrastructure (CNKI), and CBM using the key search words; 'small cell lung cancer', 'tumor marker', 'ProGRP31-98' and 'diagnostic tests', 'ELISA', 'EIA' and 'diagnostic accuracy'. Studies were collected and data analyzed to evaluate the diagnostic value of serum ProGRP31-98 levels for the diagnosis of SCLC compared with pathology. Eligibility criteria for inclusion in the analysis were based on criteria for diagnostic research published by the Cochrane Screening and Diagnostic Tests

METHODSGroup (SDTMG). The characteristics of the included articles were appraised and the data were extracted from the original articles for further statistical analysis of study heterogeneity using Review Manager 4.2 software. Based on study heterogeneity analysis, a suitable 'effect' model was selected to calculate pooled sensitivity and specificity by meta-analysis. A Summary Receiver Operating Characteristic (SROC) curve and the area under the curve (AUC) were generated and sensitivity analysis conducted.

RESULTSA total of 22 articles were entered into this meta-review, including 11 English articles with a quality at level C. In total, the studies involved 6759 subjects, of which 1470 were diagnosed with SCLC by pathology, and 5289 subjects diagnosed with non-SCLC (NSCLC). The meta-analysis showed that heterogeneity among studies was high (P = 0.00001, I(2) = 86.8%). With ELISA, the pooled sensitivity was 0.72 (0.70 to 0.75 at 95%CI) and the pooled specificity was 0.93 (0.92 to 0.94 at 95%CI); the SROC and the AUC were 0.8817. These data suggest that ProGRP31-98 has a relatively high rate of missed diagnosis (28%), but a relatively low rate of misdiagnosis (7%).

CONCLUSIONFrom meta-analysis, we concluded that serum ProGRP31-98 is a valuable marker with a high specificity for diagnosis of SCLC with a similar diagnostic accuracy to pathology.

Humans ; Peptide Fragments ; blood ; Recombinant Proteins ; blood ; Sensitivity and Specificity ; Small Cell Lung Carcinoma ; blood ; diagnosis

Non-small cell lung cancer is one of the leading causes of all cancer deaths, but despite years of research, it is still difficult to predict the response and clinical outcome of the disease. In recent years, new treatment strategies targeting the epidermal growth factor receptors (EGFR) have been developed. EGFR is one of the most frequently over expressed proteins in various cancers, including lung cancer, and signaling through this receptor has been known to cause tumor progression as well as resistance to different treatments. Therefore, EGFR has become an attractive target for various treatment strategies. However, it is important to note that not all patients with lung cancer are suitable for targeted treatment, and that patients should be selected for this treatment. Several studies have proven that the status of the EGFR can be both an indicator of suitability for treatment with, and predict the likelihood of response to EGFR targeted therapy. There are many standard techniques to be used for the detection of EGFR. This overview summarizes the ongoing and future investigations to determine the status of the EGFR.
Carcinoma, Non-Small-Cell Lung ; blood ; metabolism ; Humans ; Receptor, Epidermal Growth Factor ; blood ; metabolism

BACKGROUND: About 30% to 40% of the patients with pathologic stage I non-small cell lung cancer (NSCLC) die within 5 years after complete resection. The identification of poor prognostic factors and the application of additional treatment are very important to improve the survival rate in resected stage I NSCLC. MATERIALS AND METHODS: Sixty-eight (68) patients who had been diagnosed postoperatively between Janury 1989 and December 1995 as having stage I non-small cell lung cancer according to the TNM classification were studied. The postoperative 5-year survival rate was calculated with the Kaplan-Meier method, and clinico-histopathologic factors including age, sex, operative method, type of tumor cell, T factor, grade of the differentiation in a squamous cell carcinoma, invasion of blood vessel and expression of the nm23-H1 protein were investigated and analyzed. RESULTS: The median survival of the entire group of patients was 58+/-3 months, with a 5-year survival of 58.9%. In univariate analysis, invasion of blood vessel and poor differentiation of the tumor cell in a squamous cell carcinoma significantly worsened the survival. In multivariate analysis, invasion of blood vessel and grade of the differentiation of the tumor cells in a squamous cell carcinoma remained independent prognostic factors. High expression of the nm23-H1 protein was related to a high postoperative 5-year survival in comparision with low expression of the nm23-H1 pretein (73.0% vs 50.7%), but there was no statistical significance. CONCLUSIONS: These results highlight the negative prognostic value of poor differentiation of tumor cells in a squamous cell carcinoma and invasion of blood vessel in stage I non-small cell lung cancer. Also, further studies are necessary to be determined prognostic value of the T factor and expression of the nm23 protein in non-small cell lung cancer.
Blood Vessels ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Classification ; Humans ; Lung ; Multivariate Analysis ; Survival Rate

Carcinoma, Non-Small-Cell Lung ; blood ; mortality ; Female ; Humans ; Male ; Vascular Endothelial Growth Factor A ; metabolism

To investigate the clinical value of serum tumor marker isocitrate dehydrogenase 1(IDH1)in the diagnosis of lung cancer. The general data were collected in lung cancer patients and non-lung cancer patients.The serum level of IDH1 was detected by enzyme-linked immunosorbent assay to evaluate its clinical significance in diagnosing lung cancer. The serum IDH1 level was significantly higher in lung cancer patients than in non-lung cancer patients [(7.12±6.98)ng/ml (2.09±1.83)ng/ml,=11.540,<0.001].The serum IDH1 level in patients with adenocarcinoma or squamous cell carcinoma was significantly higher than that in patients with small cell lung cancer [(7.91±7.26)ng/ml (2.76±2.27)ng/ml, =6.345,<0.001].The sensitivity of IDH1 in detecting lung cancer,stage Ⅰ/Ⅱ lung cancer,and stage Ⅲ/Ⅳ lung cancer was 47.4%,49.1%,and 46.3%,respectively. Serum IDH1 has high sensitivities and specificities in the diagnosis and differential diagnosis of non-small cell lung cancer(squamous cell carcinoma and adenocarcinoma)and small cell lung cancer as well as the auxiliary diagnosis of stage Ⅰ and Ⅱ lung cancer.It is a valuable marker for the auxiliary diagnosis of lung cancer.
Biomarkers, Tumor ; Carcinoma, Non-Small-Cell Lung ; Humans ; Isocitrate Dehydrogenase ; blood ; Lung Neoplasms

Leptomeningeal metastasis occurs in approximately 1% of patients with non-small cell lung cancer and this is an extremely serious complication. Without treatment, the median survival of patients is 4~6 weeks. The treatment options currently available are limited and achieve only modest results. Gefitinib was recently approved for the treatment of advanced/refractory non-small cell lung cancer. In addition, there have been case reports showing activity of gefitinib against brain metastasis in non-small cell lung cancer patients. However, there is limited data on the ability of gefitinib to cross the blood-brain barrier. We report the case of a patient with leptomeningeal metastasis from adenocarcinoma of the lung that had a dramatic response to gefitinib treatment.
Adenocarcinoma ; Blood-Brain Barrier ; Brain ; Carcinoma, Non-Small-Cell Lung ; Humans ; Lung ; Neoplasm Metastasis ; Quinazolines

BACKGROUND: Adhesion molecules are related to cell-to-cell interaction and inflammatory interaction. In addition, adhesive interactions between tumor cells and adjacent cells and/or extracellular matrix play important roles in the complex process of tumor growth and development. Among these adhesion molecules, expression of intercellular adhesion molecule-1 (ICAM-1) has been identified in colon cancer, bladder cancer, lung cancer, melanoma, pancreatic cancer and hepatocellular carcinoma. In the current study, we analyzed serum ICAM-1 concentrations to investigate the relationship between the serum ICAM-1 level and prognosis in patients with lung cancer METHODS: Serum ICAM-1 was measured in 84 patients with lung cancer according to the pathologic type and clinical stage using the ICAM-1 ELISA kit. The Kaplan-Meier method was used to analyse survival time. RESULTS: There was no difference in serum ICAM-1 concentration among the different stages of lung cancer. Furthermore, there was no difference observed between histologic tumor type with regard to serum ICAM-1 concentration. Although the difference was not significant, the overall survival times of patients with a low serum ICAM-1 concentration (< 306 ng/mL) was longer than that of patients with a high concentration (> or=306 ng/mL) in non-small cell lung cancer patients. CONCLUSION: These results suggest that high levels of serum ICAM-1 reflect poor prognosis for patients with non-small cell lung cancer.
Aged ; Carcinoma, Non-Small-Cell Lung/*blood/mortality/pathology ; Carcinoma, Small Cell/*blood/mortality/pathology ; Female ; Human ; Intercellular Adhesion Molecule-1/*blood ; Lung Neoplasms/*blood/mortality/pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Analysis

OBJECTIVETo identify serum diagnosis or progression biomarkers in patients with lung cancer using protein chip profiling analysis.

METHODProfiling analysis was performed on 450 sera collected from 213 patients with lung cancer, 19 with pneumonia, 16 with pulmonary tuberculosis, 65 with laryngeal carcinoma, 55 with laryngopharyngeal carcinoma patients, and 82 normal individuals. A new strategy was developed to identify the biomarkers on chip by trypsin pre-digestion.

RESULTSProfiling analysis demonstrated that an 11.6 kDa protein was significantly elevated in lung cancer patients, compared with the control groups (P < 0.001). The level and percentage of 11.6 kDa protein progressively increased with the clinical stages I-IV and were also higher in patients with squamous cell carcinoma than in other subtypes. This biomarker could be decreased after operation or chemotherapy. On the other hand, 11.6 kDa protein was also increased in 50% benign diseases of lung and 13% of other cancer controls. After trypsin pre-digestion, a set of new peptide biomarkers was noticed to appear only in the samples containing a 11.6 kDa peak. Further identification showed that 2177 Da was a fragment of serum amyloid A (SAA, MW 11.6 kDa). Two of the new peaks, 1550 Da and 1611 Da, were defined from the same protein by database searching. This result was further confirmed by partial purification of 11.6 kDa protein and MS analysis.

CONCLUSIONSAA is a useful biomarker to monitor the progression of lung cancer and can directly identify some biomarkers on chip.

Adenocarcinoma ; blood ; pathology ; Adult ; Aged ; Biomarkers, Tumor ; blood ; Carcinoma, Small Cell ; blood ; pathology ; Carcinoma, Squamous Cell ; blood ; pathology ; Female ; Humans ; Lung Neoplasms ; blood ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Peptides ; blood ; Protein Array Analysis ; Serum Amyloid A Protein ; analysis

OBJECTIVETo determine the cut-off value of serum neuron-specific enolase (NSE) level for distinguishing small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).

METHODSSerum NSE levels were measured by enzyme-linked immunosorbent assay in 137 patients with NSCLC or SCLC, and the best cut-off value was analyzed using ROC curve.

RESULTSThe positivity rate of serum NSE was significantly higher in patients with SCLC than in those with NSCLC (P<0.01). The best cut-off value was 15.45 microg/L using ROC curve, which gave a sensitivity of 66.7% and specificity of 65.7%.

CONCLUSIONSerum NSE level may allow simple and cost-effective differentiation of SCLC and NSCLC.

Biomarkers, Tumor ; blood ; Carcinoma, Non-Small-Cell Lung ; enzymology ; pathology ; Carcinoma, Small Cell ; enzymology ; pathology ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms ; enzymology ; pathology ; Male ; Middle Aged ; Phosphopyruvate Hydratase ; blood

OBJECTIVETo explore the diagnostic value of carcinoembryonic antigen (CEA) and cytokeratin-19-fragment (CYFRA21-1) in lung cancer patients.

METHODSThe levels of serum CEA and CYFRA21-1 were measured in 102 patients with lung cancer, 45 patients with benign lung disease and 36 health controls by electrochemiluminescence.

RESULTSThe level of serum CEA and positive rate [(25.77 ± 15.34) ng/ml, 47.1%] were significantly higher in the lung cancer group than that in the benign lung disease group [(4.67 ± 2.21) ml, 7.7%; P < 0.05] and controls [(3.98 ± 3.00) ng/ml, 3.8%; P < 0.05], The level of serum CYFRA21-1 and positive rate [(14.08 ± 8.34) ng/ml, 62.7%] were also significantly higher in the lung cancer group than that in the benign lung disease group [(3.27 ± 2.87) ml, 7.7%; P < 0.05] and controls [(2.69 ± 2.02 ng/ml, 3.8%; P < 0.05]. The difference of level of CEA and CYFRA21-1 between the benign lung disease group and controls was statistically not significant (P > 0.05). Both tumor markers were increased to a different degree in the lung cancer patients at various TNM stages [(CEA: stage II (17.78 ± 8.71) ng/ml, stage III (25.84 ± 7.34) ng/ml, stage IV (34.85 ± 6.99) ng/ml; and CYFRA21-1: stage II (10.05 ± 6.76) ng/ml, stage III (15.93 ± 6.66) ng/ml, stage IV (22.78 ± 4.12) ng/ml]. Combined use of both makers showed a significant higher sensitivity (77.5% vs. 47.1%, 62.8%), but reduced specificity (86.8% vs. 94.0%, 95.6%), and not significantly changed accuracy (83.5% vs. 77.1%, 83.8%) in the diagnosis of lung cancer.

CONCLUSIONSCEA and CYFRA21-1 employed separately are helpful in the diagnosis of lung cancer. Combined detection of these two tumor markers can improve the positivity for diagnosis of lung cancer.

Adult ; Aged ; Aged, 80 and over ; Antigens, Neoplasm ; blood ; Biomarkers, Tumor ; blood ; Carcinoembryonic Antigen ; blood ; Carcinoma, Non-Small-Cell Lung ; blood ; diagnosis ; pathology ; Case-Control Studies ; Female ; Humans ; Keratin-19 ; blood ; Lung Diseases, Obstructive ; blood ; Lung Neoplasms ; blood ; diagnosis ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonia ; blood ; Small Cell Lung Carcinoma ; blood ; diagnosis ; pathology ; Tuberculosis, Pulmonary ; blood