Abstract
The periostin protein is expressed in a variety of human malignancies. The aim of this study was to explore the diagnostic and prognostic value of serum periostin levels in patients with non-small cell lung cancer (NSCLC). We measured serum periostin levels by ELISA in 296 NSCLC patients, 120 benign lung diseases (BLD) patients and 160 healthy controls. The levels of serum periostin in NSCLC patients were significantly elevated compared with those in healthy controls (P < 0.001) and BLD patients (P < 0.001). Using a cutoff value of 30.87 ng/ml, the sensitivity and specificity of periostin in differentiating between NSCLC patients and BLD patients, and between NSCLC patients and healthy controls was, 48.6 and 91.7%, and 51.4 and 97.5%, respectively. Kaplan-Meier log rank analysis revealed that the higher serum periostin levels group had a poorer progression-free survival (PFS) and overall survival (OS) compared with lower periostin group (P = 0.024, P = 0.015, respectively). Further univariate and multivariate Cox regression analysis showed that serum periostin was an independent risk factor of prognosis of NSCLC patients. In conclusion, our study suggests that serum periostin could be considered as a diagnostic and prognostic marker for NSCLC patients.
Highlights
Lung cancer is the leading cause of cancer-related death in the world [1]
Serum periostin levels were similar in healthy controls and benign lung diseases (BLD) patients (P > 0.05)
Previous studies have showed that periostin has been upregulated in non-small cell lung cancer (NSCLC) tissue, these studies were restricted to quantitative polymerase chain reaction or immunohistochemical assessment of periostin expression and did not concern its serum levels [14, 15, 19]
Summary
Lung cancer is the leading cause of cancer-related death in the world [1]. Non-small cell lung cancer (NSCLC) accounts for up to 80–85% of lung cancer [2]. Most of the lung cancer patients have advanced stage, so that patients have little effective treatment, and this presents five years survival rates of less than 15% [3, 4]. Several tumor markers such as carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), and neuron-specific enolase (NSE) have been used as biomarker for lung cancer. None of them showed satisfactory for diagnosis because of their low sensitivity and specificity. Biomarkers for diagnosis and prognosis of lung cancer are urgently needed [5]
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