Three-marker Assay for Early Detection of Renal Cancer


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Early detection of renal cell carcinoma using biomarkers remains challenging. Kim and colleagues recently evaluated a three-marker assay consisting of nicotinamide N-methyltransferase (NNMT), L-plastin (LCP1), and nonmetastatic cells 1 protein (NM23A).

After validation of the three-marker assay in patients with renal cell carcinoma and control subjects, a scoring method based on the cut-point of each of the three markers was used to evaluate the diagnostic performance of the marker combination. Plasma levels of NNMT, LCP1, and NM23A were highly elevated in patients with renal cell carcinoma (P < .0001).

In 289 blind sample tests with 175 control subjects and 114 patients with kidney cancer, the diagnostic accuracies of NNMT alone and the three-marker assay were 0.913 and 0.932, respectively. When 90% specificity was defined, the sensitivities of NNMT and the three-marker assay were 71.9% and 95.7%, respectively. The three-marker assay had a positive predictive value of 87.2% and a negative predictive value of 97%.

The investigators concluded, “The composite assay with NNMT, LCP1, and NM23A [is] a promising novel serum marker assay for the early detection of malignant kidney tumors covering subtypes of [renal cell carcinoma] with high diagnostic characteristics. NNMT/LCP1/NM23A triple markers could be a helpful screening assay to detect early [renal cell carcinoma].” ■

Kim DS, Choi YD, Moon M, et al: Composite three-marker assay for early detection of kidney cancer. Cancer Epidemiol Biomarkers Prev 22:390-398, 2013.

Lab Notes is compiled and written for The ASCO Post by Matthew Stenger.



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