Abstract
Intrathoracic cancers, including lung cancer, mesothelioma, and thymoma, present diagnostic challenges in primary care. Biomarkers could resolve some challenges. We synthesized evidence on biomarkers performance for intrathoracic cancer detection in low-prevalence settings.
A search in EMBASE and MEDLINE included studies that recruited participants with suspected intrathoracic cancer and reported on at least one diagnostic measure for a validated, non-invasive biomarker. Studies were excluded if participants were recruited based on a pre-established diagnosis. Fifty-two studies were included, reporting on 108 individual biomarkers and panels. CEA, CYFRA 21.1, and VEGF were evaluated for lung cancer and mesothelioma. For lung cancer, CEA and CYFRA 21.1 were most studied, with AUCs of 0.48-0.90 and 0.48-0.83, respectively. Pro-GRP and NSE had the highest NPVs (98.2%, 96.9%), while Early-CDT and MSC panels showed
NPVs of 99.3% and 99.0% in smokers. For mesothelioma, Fibrillin-3 and mesothelin plus osteopontin had AUCs of 0.93 and 0.91, respectively. Thymoma panels (Binding AcHR + StrAb) and (Binding AcHR + Modulating AcHR + StrAb) had 100% NPVs in myasthenia gravis patients.
The review highlights the performance of some biomarkers. However, few were evaluated in low-prevalence settings. Further evaluation is necessary before implementing these biomarkers for intrathoracic cancers in primary care.
A search in EMBASE and MEDLINE included studies that recruited participants with suspected intrathoracic cancer and reported on at least one diagnostic measure for a validated, non-invasive biomarker. Studies were excluded if participants were recruited based on a pre-established diagnosis. Fifty-two studies were included, reporting on 108 individual biomarkers and panels. CEA, CYFRA 21.1, and VEGF were evaluated for lung cancer and mesothelioma. For lung cancer, CEA and CYFRA 21.1 were most studied, with AUCs of 0.48-0.90 and 0.48-0.83, respectively. Pro-GRP and NSE had the highest NPVs (98.2%, 96.9%), while Early-CDT and MSC panels showed
NPVs of 99.3% and 99.0% in smokers. For mesothelioma, Fibrillin-3 and mesothelin plus osteopontin had AUCs of 0.93 and 0.91, respectively. Thymoma panels (Binding AcHR + StrAb) and (Binding AcHR + Modulating AcHR + StrAb) had 100% NPVs in myasthenia gravis patients.
The review highlights the performance of some biomarkers. However, few were evaluated in low-prevalence settings. Further evaluation is necessary before implementing these biomarkers for intrathoracic cancers in primary care.
| Original language | English |
|---|---|
| Pages (from-to) | 19-34 |
| Number of pages | 16 |
| Journal | Cancer Epidemiology, Biomarkers and Prevention |
| Volume | 34 |
| Issue number | 1 |
| Early online date | 14 Oct 2024 |
| DOIs | |
| Publication status | Published - 1 Jan 2025 |
Bibliographical note
AcknowledgmentsWe thank Isla Kuhn at the University of Cambridge for her help developing the search strategies and for retrieving full text of several articles identified in database searches. This project is funded by the National Institute for Health and Care Research (NIHR) School for Primary Care Research (grant reference number 577). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon request.Keywords
- Biomarkers, Tumor/blood
- Early Detection of Cancer/methods
- Humans
- Lung Neoplasms/diagnosis
- Primary Health Care
- Thoracic Neoplasms/diagnosis
Access to Document
- Hamad_etal_CEBP_Biomarkers_Suitable_For_VOR
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