Circulating and local nuclear expression of survivin and fibulin-3 genes in discriminating benign from malignant respiratory diseases: correlation analysis

Our plain-English summary of Circulating and local nuclear expression of survivin and fibulin-3 genes in discriminating benign from malignant respiratory diseases: correlation analysis, by M.H. Hassan, S. Abuhamdah, M. Abdel-Bary, et al (Bioscience Reports, 2021).

The study

• Authors: M.H. Hassan, S. Abuhamdah, M. Abdel-Bary, M. Wahman, T.H. Abd-Elhamid, M. Beshay, K. Mosallam, B.E.M. Elsadek
• Journal: Bioscience Reports
• Published: 2021;41(1)
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Survivin is an inhibitor of apoptosis as well as a promoter of cell proliferation. Fibulin-3 is a matrix glycoprotein that displays potential for tumor suppression or propagation. The present study aimed to validate the expression levels of survivin and fibulin-3 in benign and malignant respiratory diseases. This case-control study included 219 patients categorized into five groups. Group A included 63 patients with lung cancer, group B included 63 patients with various benign lung diseases, group D included 45 patients with malignant pleural mesothelioma (MPM), and group E included 48 patients with various benign pleural diseases. Group C included 60 healthy individuals (control group). Serum survivin and fibulin-3 levels were measured by ELISA, whereas their nuclear expressions in the lung and pleura were assessed via Western blot analysis. The results showed significantly higher survivin serum levels and significantly lower fibulin-3 levels in group A compared with in group B and controls (P<0.001). There were significantly higher serum levels of survivin and fibulin-3 in group D compared with in group E and controls (P<0.001), consistent with observed nuclear survivin and fibulin-3 expression levels. Fibulin-3 was determined to have higher value than survivin in discriminating lung cancer from MPM (P<0.05). Survivin and fibulin-3 could be useful diagnostic markers for lung and pleural cancers, and fibulin-3 expression was particularly useful in differentiating lung cancer from MPM.

© 2020 The Author(s).

In plain English

This case-control study at Qena University Hospitals, Egypt, from January 2017 to December 2019, measured the proteins survivin and fibulin-3 in the blood of 219 patients and 60 healthy controls. The patients had lung cancer (63), benign lung diseases (63), malignant pleural mesothelioma (45) or benign pleural diseases (48). The authors also measured the proteins in lung and pleural biopsy tissue. The article does not report asbestos exposure for any group. Patients with lung cancer had higher blood survivin and lower blood fibulin-3 than patients with benign lung disease and controls. Patients with mesothelioma had higher blood levels of both proteins than patients with benign pleural disease and controls. Tissue levels were reported as consistent with blood levels. Blood levels of neither protein differed significantly by tumor stage or by the tumor's histological type. In telling lung cancer apart from mesothelioma, fibulin-3 had a sensitivity of 100.0%, a specificity of 93.3% and an area under the curve of 0.994. For survivin the area under the curve was 0.603. The authors concluded that both proteins could serve as diagnostic markers and that fibulin-3 was more useful for separating the two cancers. They named the small, single-center sample as the main limitation.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case-control study measuring blood (ELISA) and tissue (Western blot) levels of survivin and fibulin-3
• Who was studied: 219 patients in four groups: lung cancer (group A, 63), benign lung diseases (group B, 63), malignant pleural mesothelioma (group D, 45) and benign pleural diseases (group E, 48). There were also 60 age- and sex-matched healthy controls (group C). Patients came from Qena University Hospitals, South Valley University, Egypt, between January 1, 2017 and December 30, 2019.
• Exposure: No asbestos or other environmental or occupational exposure is reported. The study measured serum survivin and fibulin-3 levels and their nuclear expression in lung and pleural biopsy tissue.
• Main results:
  • Lung cancer patients had higher mean serum survivin (681.93 pg/ml) than patients with benign lung diseases (423.34 pg/ml) and controls (269.22 pg/ml), P<0.001.
  • Lung cancer patients had lower mean serum fibulin-3 (3.56 pg/ml) than patients with benign lung diseases (10.16 pg/ml) and controls (8.99 pg/ml), P<0.001.
  • Patients with malignant pleural mesothelioma had higher mean serum survivin (582.75 pg/ml) than patients with benign pleural diseases (259.7 pg/ml) and controls (269.22 pg/ml), P<0.001. They also had higher mean serum fibulin-3 (14.5 pg/ml versus 8.9 and 8.99 pg/ml), P<0.001. Benign pleural disease patients did not differ significantly from controls for either protein (P=0.873 and P=0.949).
  • Western blot results on lung and pleural tissue were reported as consistent with blood levels. Tissue fibulin-3 was significantly lower in lung cancer patients than in mesothelioma patients.
  • Serum survivin and fibulin-3 did not differ significantly by tumor stage or by histological type in either lung cancer or mesothelioma patients.
  • For predicting mesothelioma, survivin (cut-off above 263.6 pg/ml) had sensitivity 82.86%, specificity 75.0% and AUC 0.804. Fibulin-3 (cut-off above 11.7 pg/ml) had sensitivity 37.14%, specificity 100.0% and AUC 0.680. The difference between the two markers was not significant (P>0.05).
  • For discriminating lung cancer from mesothelioma, fibulin-3 (cut-off at or below 9.16 pg/ml) had sensitivity 100.0%, specificity 93.3% and AUC 0.994. Survivin (cut-off above 632 pg/ml) had sensitivity 52.38%, specificity 86.67% and AUC 0.603 (P<0.001).
• The authors' conclusion: The authors concluded that serum survivin and fibulin-3 could be used as diagnostic markers for lung cancer and malignant pleural mesothelioma. They found no significant difference between the two markers in predicting either cancer from benign disease, but judged serum fibulin-3 more useful in differentiating lung cancer from mesothelioma.
• Limitations the authors state:
  • Relatively small sample size recruited from a single hospital center

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Fibulin-3, Apoptosis, Glycoprotein, Case-Control Study, Lung Cancer, Pleural Mesothelioma, Pleura.

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