Abstract
Introduction
The use of chromogranin A (CGA) as a circulating biomarker in lung carcinoids (LCs)
is limited by low specificity and sensitivity. This study aimed to evaluate plasma
progastrin-releasing peptide (ProGRPp) as an alternative to plasma CGA (CGAp), for
the diagnosis and follow-up of LC.
Methods
ProGRPp and CGAp concentrations were measured in 107 patients with LC and 105 patients
with benign lung disease (BLD).
Results
ProGRPp distinguished patients with LC with active disease in the pretreatment (n =
43) and post-treatment (n = 43) groups from those with BLD: area under the curve for
both 0.864 (p < 0.0001); sensitivity 67.4% and 58.1%, respectively; specificity 96.2%; at 64 pg/mL
cutoff. CGAp failed to differentiate both LC groups from those with BLD: area under
the curve 0.579 and 0.526 (for both p > 0.1); sensitivity 34.9% and 25.6%, respectively; specificity 73.3%; at 104 ng/mL
cutoff. Only ProGRPp correlated with the Ki67 proliferation index (r = 0.40, p < 0.001) and was associated with mitotic count (p = 0.025), stage (p = 0.018), grade (p = 0.019), and the expression of thyroid transcription factor-1 (p = 0.005). ProGRPp had a high sensitivity (92.3%) in LC with diffuse idiopathic pulmonary
neuroendocrine cell hyperplasia. Abnormal postoperative ProGRPp level was associated
with residual disease (p = 0.029). The changes in ProGRPp level during treatment, a decrease greater than
30% and an increase greater than 8%, were associated with image-based outcomes, partial
response and disease progression, respectively (p < 0.0001). CGAp did not reflect the disease course.
Conclusions
ProGRPp was superior to CGAp in diagnosing LC with correlations concerning proliferation,
grading, staging, diffuse idiopathic pulmonary neuroendocrine cell hyperplasia co-occurrence,
and response to treatment. ProGRPp is an optimal emerging biomarker to be further
evaluated.
Keywords
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Article info
Publication history
Published online: December 08, 2022
Accepted:
November 18,
2022
Received in revised form:
November 10,
2022
Received:
June 22,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Drs. Nisman and Oleinikov contributed equally as joint first authors.
Drs. Meirovitz and Grozinsky-Glasberg contributed equally as joint senior authors.
Disclosure: The authors declare no conflict of interest.
Identification
Copyright
© 2022 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.
