Age-stratified and gender-specific reference intervals of six tumor markers panel of lung cancer: A geographic-based multicenter study in China

J Clin Lab Anal. 2021 Jun;35(6):e23816. doi: 10.1002/jcla.23816. Epub 2021 May 12.

Abstract

Background: Serum biomarkers have been widely adopted in clinical practice for assisting lung cancer diagnoses, therapeutic monitoring, and prognostication. The function of a well-performing tumor biomarker depends on a reliable reference interval (RI) with consideration of the study subjects' age, gender, and geographical location. This study aimed to establish a RI for each of 6 lung cancer biomarkers for use in the whole country of China on Mindray platform.

Methods: The levels of serum 6 lung cancer biomarkers-namely progastrin-releasing peptide (ProGRP), neuron-specific enolase (NSE), squamous cell carcinoma antigen (SCC), carcinoembryonic antigen (CEA), cytokeratin-19 fragment (CYFRA21-1), and human epididymis protein 4 (HE4)-were measured utilizing the chemiluminescence immunoassay on the Mindray CL-6000i platform following the laboratory standard operating procedures in apparently healthy Chinese individuals on large cohort, multicenter, and geographical consideration bases. The CLSI EP28-A3C guideline was followed for the enrollment of study subjects.

Results: The age-stratified, gender-specific RIs for ProGRP, NSE, SCC, CEA, CYFRA21-1, and HE4 lung cancer biomarkers in the Chinese population have been established as described in the results and discussion in this work. In addition, various levels of the six lung cancer biomarkers among nine geographical locations in China have been observed.

Conclusions: The sample volume of study cohort, age, and geographical location should be considered upon establishing a reliable biomarker RI. A RI for each of six lung cancer biomarkers has been established. The results from this study would be helpful for clinical laboratories in interpreting the analytical results and for clinicians in patient management.

Keywords: carcinoembryonic antigen; human epididymis protein 4; lung neoplasms; progastrin-releasing peptide; tumor biomarkers.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Antigens, Neoplasm / blood
  • Biomarkers, Tumor / blood*
  • Carcinoembryonic Antigen / blood
  • Carrier Proteins / blood
  • China
  • Cohort Studies
  • Female
  • GPI-Linked Proteins / blood
  • Geography
  • Humans
  • Immunoassay / methods*
  • Keratin-19 / blood
  • Lung Neoplasms / blood
  • Lung Neoplasms / diagnosis*
  • Male
  • Middle Aged
  • Peptide Fragments / blood
  • Prognosis
  • Recombinant Proteins / blood
  • Reference Values
  • Serpins / blood
  • Sex Factors
  • WAP Four-Disulfide Core Domain Protein 2 / analysis
  • Young Adult

Substances

  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • CEACAM5 protein, human
  • Carcinoembryonic Antigen
  • Carrier Proteins
  • GPI-Linked Proteins
  • Keratin-19
  • NSMCE1 protein, human
  • Peptide Fragments
  • Recombinant Proteins
  • Serpins
  • WAP Four-Disulfide Core Domain Protein 2
  • WFDC2 protein, human
  • antigen CYFRA21.1
  • pro-gastrin-releasing peptide (31-98)
  • squamous cell carcinoma-related antigen