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Biomarker screening identified early-stage renal cell carcinomas
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A novel immunoassay testing for the presence of three biomarkers appeared to be an applicable screening method for the early detection of malignant kidney tumors covering subtypes of renal cell carcinoma with high diagnostic characteristics.
“Renal cell carcinoma … is one of the most difficult forms of cancer to detect and treat properly because it remains silent until disseminating to other organs,” Nam Hoon Cho, MD, of the department of pathology at Yonsei University Health System in Seoul, Korea, said in a press release. “Furthermore, because imaging — which is high-cost — is seldom performed without any specific reasons, developing a blood-tumor biomarker is a great chance to detect the silent killer.”
To validate clinical performance of potential candidate markers for kidney tumors, Cho and colleagues used a three-marker assay — composed of nicotinamide N-methyltransferase (NNMT), L-plastin (LCP1) and nonmetastatic cells 1 protein (NM23A) — to measure concentrations of NNMT, LCP1 and NM23A in plasma samples from healthy controls and patients with benign tumors (n=102) and patients with kidney cancer (n=87).
The researchers had previously validated the three-marker assay with an additional 100 plasma samples from 73 healthy controls and 27 patients with kidney cancer. During that investigation, 67 of the samples from the healthy controls and all of the samples from patients with kidney cancer were classified correctly.
Researchers used a scoring method based on the cut-point of each of the three markers to assess the diagnostic performance of the marker combination.
Cho and colleagues reported that plasma levels of NNMT, LCP1 and NM23A were significantly elevated in patients with kidney cancer (P<.0001).
In 289 masked sample tests with control patients (n=175) and patients with kidney cancer (n=114), the diagnostic accuracy of NNMT alone was 0.913 compared with 0.932 for the three-marker assay. When 90% specificity was defined, the sensitivity of NNMT was 71.9% vs. 95.7% for the three-marker assay.
In addition, the three-marker assay has a positive predictive value of 87.2% (+PPV) and a negative predictive value of 97%.
“If this biomarker is truly valid and accurate to detect renal cell carcinoma, a number of patients with renal cell carcinoma could potentially be saved through early diagnosis,” Cho said.
Disclosure: The researchers report no relevant financial disclosures.
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