J Korean Med Sci.  2011 May;26(5):625-630. 10.3346/jkms.2011.26.5.625.

Plasma proGRP Concentration is Sensitive and Specific for Discriminating Small Cell Lung Cancer from Nonmalignant Conditions or Non-small Cell Lung Cancer

• Kim HR
• Oh IJ
• Shin MG
• Park JS
• Choi HJ
• Ban HJ
• Kim KS
• Kim YC
• Shin JH
• Ryang DW
• Suh SP

• KMID: 1777860
• DOI: http://doi.org/10.3346/jkms.2011.26.5.625

Abstract

To date, most clinical data on pro-gastrin-releasing peptide (proGRP) have been based on serum concentrations. This study evaluated the agreement between proGRP levels in fresh serum and plasma in patients with various lung diseases. Pairs of serum and EDTA plasma were collected from 49 healthy individuals. At the same time, EDTA plasma of 118 lung cancer patients and 23 patients with benign pulmonary diseases were prospectively collected. Compared to serum, plasma proGRP concentrations were higher by an average of 103.3%. Plasma proGRP was higher in malignancy (336.4 +/- 925.4 pg/mL) than in benign conditions (40.1 +/- 11.5 pg/mL). Small cell lung cancer (SCLC) patients showed higher levels of proGRP (1,256.3 +/- 1,605.6 pg/mL) compared to other types of lung cancer. Based on the ROC curve analyses at a specificity of 95%, the diagnostic sensitivity of plasma proGRP was estimated to be 83.8% in distinguishing SCLC from all the other conditions, and 86.5% for discriminating SCLC from the nonmalignant cases. Among the SCLC cases, limited stage disease had lower levels of plasma proGRP than extensive disease. When measuring circulating levels of proGRP, the use of plasma is preferred over serum. Plasma proGRP has a potential marker for discriminating SCLC from nonmalignant conditions or non-small cell lung cancer.

Keyword

pro-gastrin-releasing peptide (31-98); Serum; Plasma; Small Cell Lung Carcinoma

MeSH Terms

Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung/*blood/diagnosis/pathology
Diagnosis, Differential
Female
Humans
Lung Diseases/*blood
Lung Neoplasms/*blood/diagnosis/pathology
Male
Middle Aged
Peptide Fragments/*blood
Recombinant Proteins/blood
Sensitivity and Specificity
Small Cell Lung Carcinoma/*blood/diagnosis/pathology
Tumor Markers, Biological/*blood

Figure

• 

  Fig. 1 Comparison of concentrations of the 3 tumor markers between fresh serum and plasma using Passing-Bablok regression and difference plots in healthy individuals. (A) pro-gastrin-releasing peptide (proGRP): slope, 1.32; intercept, 9.62; mean difference, + 18.8. (B) squamous cell cancer antigen (SCC): slope, 1.00; intercept, 0.00; mean difference, + 0.1. (C) neuron- specific enolase (NSE): slope, 0.72; intercept, -2.99; mean difference, -5.9.

• 

  Fig. 2 Distribution of plasma proGRP concentrations in healthy individuals, benign lung diseases and lung cancer. The average proGRP level in small cell lung cancer was higher than those of other conditions except large cell lung cancer which is thought to be originated from the neuroendocrine cells. SCLC, small cell lung cancer; NSCLC, non-small cell lung cancer.

• 

  Fig. 3 Accuracy of plasma proGRP for detecting small cell lung cancer at the time of diagnosis using ROC curve analysis. The AUCs of the 2 curves were not significantly different. ROC, Receiver Operating Characteristics; AUC, area under curve.

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