Circulating Levels of L1-cell Adhesion Molecule as a Serum Biomarker for Early Detection of Gastric Cancer and Esophagogastric Junction Adenocarcinoma

Abstract

Background: Low serum L1 cell adhesion molecule (L1CAM) has been found in several malignant tumors. Here, we aimed to evaluate the diagnostic potential for serum L1CAM in patients with gastric cancers (GC) and esophagogastric junction adenocarcinoma (EJA). Methods: Enzyme-linked immunosorbent assay (ELISA) was carried out to detect L1CAM level in sera of 148 GC patients, 59 EJA patients and 148 healthy controls. Receiver operating characteristics (ROC) was employed to evaluate diagnostic accuracy. Results: The concentrations of serum L1CAM were significantly lower in GC and EJA than those in healthy controls (P<0.001). Detection of L1CAM provided a sensitivity of 83.1%, a specificity of 62.2%, and an area under the curve (AUC) of 0.769 (95% CI: 0.715-0.823) in diagnosing GC, and a sensitivity of 66.1%, a specificity of 62.2%, and an AUC of 0.672 (95% CI: 0.590-0.755) in diagnosing EJA. Similar results were observed in the diagnosis of early-stage GC (0.681 (95%CI: 0.596-0.766)) and early-stage EJA (0.674 (95%CI: 0.528-0.820)). Analysis of clinical data showed that the levels of L1CAM were significantly associated with lymph node metastasis in GC (P<0.05). Conclusions: Our study showed that serum L1CAM might be a diagnostic biomarker for GC and EJA.

Keywords: L1CAM; early diagnosis; esophagogastric junction cancer; gastric cancer; serum biomarker.

Figure 1

Level of serum L1CAM. A. Scatter plot and box plot of OD values of L1CAM from GC serum and normal serum. B. Scatter plot and box plot of OD values of L1CAM from EJA serum and normal serum. Black horizontal lines are means.

Figure 2

Receiver operating characteristic (ROC) curve analysis in the diagnosis of GC+EJA, GC, EJA, early-stage GC+EJA, early-stage GC and early-stage EJA. A. The ROC curves for serum L1CAM in patients with GC+EJA and early-stage GC+EJA compared with those in normal control group. B. The ROC curves for serum L1CAM in patients with GC and early-stage GC compared with those in normal control group. C. The ROC curves for serum L1CAM in patients with EJA and early-stage EJA compared with those in normal control group. The area under the block line is 0.5, for reference.