Evaluation of albumin and lactate dehydrogenase in comparison with cytokeratin 19 fragments and neuron-specific enolase as diagnostic biomarkers for non-small cell lung cancer

Abstract

Background

The diagnosis of non-small cell lung cancer (NSCLC) is a clinical issue that requires attention, and more practical and effective biomarkers need to be selected to assist in diagnosis. This study aimed to examine the diagnostic value of serum albumin (ALB), lactate dehydrogenase (LDH), cytokeratin 19 fragments (CYFRA21-1), and neuron-specific enolase (NSE) for NSCLC.

Methods

The clinical data of 1048 NSCLC patients and 1125 healthy subjects were extracted from electronic medical records. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic significance of ALB, LDH, CYFRA21-1, and NSE for NSCLC. The Cancer Genome Atlas (TCGA) data, which included mRNA profiles for ALB and LDH expression, were acquired from TCGA Program. Finally, interactive survival scatter plots and survival analyses for NSCLC patients were evaluated using the Human Protein Atlas and Kaplan–Meier Plotter.

Results

Significant differences were noted in the levels of ALB and LDH between NSCLC patients and healthy controls. The areas under the ROC curves (AUCs) for ALB and LDH were 0.754 (95% CI: 0.734–0.774) and 0.681 (95% CI: 0.658–0.704), respectively. Moreover, the combination of ALB and LDH raised the AUC to 0.804 (95% CI: 0.785–0.823), and the incorporation of CYFRA21-1 and NSE further increased the AUC to 0.903 (95% CI: 0.890–0.916). Notably, ALB and LDH might be related to the overall survival of NSCLC patients.

Conclusion

This study revealed that ALB and LDH in NSCLC patient serum could improve the diagnostic accuracy of conventional biomarkers for NSCLC.