Abstract:

Objective To investigate the expression level of tumor biomarker human epididymis protein 4 (HE4) in tissue and serum of patients with lung cancer and its role in differential diagnosis of lung cancer. Methods HE4 expressions in lung adenocarcinoma, lung squamous cell carcinoma and cancer-adjacent tissues were detected by immunohistochemistry, and serum HE4 levels were determined in 214 patients with lung cancer and 76 healthy subjects by enzyme-linked immunobsorbent assay (ELISA). Simultaneously, the serum levels of squamous cell carcinoma antigen (SCC), carcinoembryonic antigen (CEA), cytokeratin 19 fragment(CYFRA21-1) and neuron-specific enolase (NSE) were determined. The results were compared and analyzed among the groups. Results Lung adenocarcinoma tissues showed stronger positive staining than lung squamous cell carcinoma tissues, and the negative staining was shown in cancer-adjacent tissues. The level of serum HE4 in lung cancer patients[85.04(64.91,118.40) pmol/L] was significantly higher than that of healthy controls [48.48(43.12,58.81) pmol/L, P<0.01]. HE4 had a better diagnosis efficiency than CYFRA21-1 and CEA in non-small cell lung cancer through receiver operating characteristic (ROC) curve analysis. The positive rate of combined detection of SCC, CEA, CYFRA21-1 and NSE was 79.44% for lung cancer. However, HE4 improved the positive rate to 89.72% when combined with this biomarker panel. In the diagnosis of lung adenocarcinoma, the positive rate of combined detection of CEA and CYFRA21-1 was 68.46%. Moreover, HE4 improved the positive rate to 82.31% when combined with this biomarker panel. Conclusions HE4, as a biomarker of lung cancer, is a useful indicator for the early diagnosis of lung cancer.

Key words: Human epididymis protein 4, Lung cancer, Tumor biomarker