Can NGAL be employed as prognostic and diagnostic biomarker in human cancers? A systematic review of current evidence
Int J Biol Markers 2017; 32(1): e53 - e61
Article Type: REVIEW
AuthorsLaura Roli, Valentina Pecoraro, Tommaso Trenti
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.
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.
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).
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.
- • Received on 06/10/2016
- • Accepted on 17/11/2016
- • Available online on 16/01/2017
- • Published online on 02/03/2017
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- Roli, Laura [PubMed] [Google Scholar] 1
- Pecoraro, Valentina [PubMed] [Google Scholar] 2, * Corresponding Author (firstname.lastname@example.org)
- Trenti, Tommaso [PubMed] [Google Scholar] 2
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