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Can NGAL be employed as prognostic and diagnostic biomarker in human cancers? A systematic review of current evidence

Can NGAL be employed as prognostic and diagnostic biomarker in human cancers? A systematic review of current evidence

Post author correction

Article Type: REVIEW

Article Subject: Cancer Epidemiology Biomarkers

DOI:10.5301/jbm.5000245

Authors

Laura Roli, Valentina Pecoraro, Tommaso Trenti

Abstract

Background

Some studies have reported differentially altered neutrophil gelatinase-associated lipocalin (NGAL) levels in several malignancies. We evaluated NGAL measured in plasma or urine as both prognostic and diagnostic marker for different types of human tumors.

Methods

We performed systematic electronic searches in Medline, Embase and CRDTAS. Studies were included if they evaluated NGAL as a prognostic or diagnostic marker for human cancers. The selection of the studies, screening of the full texts and data extraction were conducted independently by 2 authors. We used the random-effects model for the meta-analyses. A methodological assessment was completed.

Results

We included 35 studies dedicated to colorectal, pancreas, breast, thyroid, gastric, kidney, endometrial, brain, liver, lung, esophageal, oral and ovarian cancers. Our meta-analyses showed that, in patients with colorectal and breast cancer, positive NGAL expression was associated with a decrease of disease-free survival (hazard ratio [HR] = 2.27, 95% confidence interval [95% CI], 1.54-3.36; HR = 1.78, 95% CI, 1.33-2.38, respectively). NGAL was a negative prognostic marker of overall survival in colorectal (HR = 2.37, 95% CI, 1.68-3.34) and endometrial (HR = 4.38, 95% CI, 1.9-10.12) cancers. Discriminative power of NGAL between cancer patients and control was moderate in colorectal cancer (area under the curve [AUC] = 0.6; pooled sensitivity 0.56; pooled specificity 0.72), acceptable in pancreatic cancer (AUC = 0.8; pooled sensitivity 0.6; pooled specificity 0.8) and good in thyroid cancer (AUC = 0.9; pooled sensitivity 0.85; pooled specificity 0.96).

Conclusions

NGAL determination in plasma and urine could be useful in the prognosis of colorectal and breast cancer, but its prognostic accuracy remains uncertain for other human tumors.

Article History

Disclosures

Financial support: No specific funding was received for this work.
Conflict of interest: The authors state that there are no conflicts of interest regarding the publication of this article.

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Authors

Affiliations

  • Laboratory of Endocrinology, Department of Laboratory Medicine and Pathological Anatomy, Azienda USL of Modena, Modena - Italy
  • Laboratory of Toxicology, Department of Laboratory Medicine and Pathological Anatomy, Azienda USL of Modena, Modena - Italy

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