Pyroptosis-Mediator GSDMD in Plasma: A Potent Biomarker Lung Cancer Diagnosis and Prognosis Assessment

Lung cancer's high mortality is linked to late diagnosis, with current methods having limitations. This study aimed to evaluate the diagnostic efficacy of Gasdermin D (GSDMD) in lung cancer and explore its biological functions.

A total of 114 lung cancer patients, 87 patients with pulmonary nodules, and 100 healthy controls were enrolled. Clinical data were collected, and venous blood samples were obtained. GSDMD, carcinoembryonic antigen (CEA), neuron - specific enolase (NSE), cytokeratin 19 fragment (CYFRA21 - 1), and other markers were measured using specific assays. Statistical analysis, including variance tests, ANOVA, and logistic regression, was performed to analyze the data.

There were no significant differences in age and gender among the three groups. However, GSDMD levels were highest in the lung cancer group, followed by the pulmonary nodule group, and lowest in the healthy control group (P < 0.05). GSDMD was positively correlated with multiple biomarkers such as CEA (r = 0.329, P < 0.001), NSE (r = 0.266, P < 0.001), and CYFRA21 - 1 (r = 0.477, P < 0.001). Multivariate logistic regression analysis indicated that serum GSDMD, CEA, SCC, HE4, and IL - 6 were independent risk factors for lung cancer. The area under the ROC curve (AUC) of plasma GSDMD was 0.860, higher than that of CEA (0.801) and SCC (0.843). At a plasma GSDMD cut - off value of 39.87 pg/mL, the diagnostic sensitivity was 95.6%, and the specificity was 72.2%. When combined with other biomarkers (CEA, SCC, and HE4), the AUC reached 0.959, with a sensitivity of 93.0% and a specificity of 82.9%.

GSDMD holds promise as a diagnostic/prognostic biomarker for lung cancer, alone or combined with other markers, enhancing risk assessment accuracy to aid early detection and improve outcomes.