Prognostic significance of serum chemerin levels in patients with non-small cell lung cancer

Abstract

Chemerin plays an important role in adipogenesis and chemotaxis of the innate immune system. The aim of this study was to explore the significance and prognostic value of serum chemerin levels in patients with non-small cell lung cancer (NSCLC). Serum specimens from 189 NSCLC patients and 120 healthy controls were collected. The levels of serum chemerin were measured by sandwich enzyme-linked immunosorbent assay (ELISA). The serum chemerin levels were significantly elevated in NSCLC patients compared with healthy controls (P < 0.001). Higher serum chemerin levels were associated with advanced TNM stage, lymph node metastasis, and distant metastasis. Area under receiver operating characteristic curve (ROC) for serum chemerin was 0.809 (95% CI: 0.722-0.896) at a sensitivity of 0.624 and of specificity 0.675. The cut-off value of chemerin was 1500 pg/ml for discriminating NSCLC from healthy controls. Kaplan-Meier log rank analysis revealed that the higher serum chemerin patients had a shorter overall survival (OS) and progression-free survival (PFS) compared with lower chemerin patients (P = 0.004, P = 0.001, respectively). Further univariate and multivariate Cox regression analysis showed that serum chemerin was an independent risk factor of prognosis of NSCLC patients. In conclusion, measurement of chemerin might be a useful diagnostic and prognostic biomarker for NSCLC patients.

Keywords: biomarker; chemerin; diagnosis; non-small cell lung cancer; prognosis.

Figure 1

Comparison of serum chemerin levels (A) between healthy controls and NSCLC patients; (B) in healthy controls and NSCLC patients at different TNM stage; (C) in NSCLC patients with and without lymph node metastasis; (D) in NSCLC patients with and without distant metastasis.

Figure 2

ROC curves for the serum chemerin (A) and CEA (B) and chemerin + CEA (C) in differentiating NSCLC patients and healthy controls. The areas under the curve of serum chemerin, CEA and chemerin + CEA were 0.809, 0.64 and 0.906, respectively.

Figure 3. Kaplan–Meier survival curves for PFS and OS in patients with chemerin -high and -low NSCLC

Log-rank test determined that the PFS and OS in high chemerin group were significantly longer than those in the low chemerin group (P = 0.001; P = 0.004).