Investigating the diagnostic significance of serum NRCAM in small cell lung cancer

This study aims to investigate the clinical significance of serum neuronal cell adhesion molecule (NRCAM) in small cell lung cancer (SCLC) diagnosis.

Serum NRCAM levels were measured using enzyme-linked immunosorbent assay in 80 SCLC patients, 98 patients with non-small cell lung cancer (NSCLC), 73 patients with pulmonary nodules (PN) and 56 healthy controls. Neuron specific enolase (NSE) and progastrin-releasing peptide (ProGRP) expression were detected using chemiluminescence immunoassay.

(1) Significant differences were detected in serum NRCAM, NSE and ProGRP levels among the groups (P < 0.05), with the highest levels observed in SCLC patients. (2) Correlation assessment revealed that serum NRCAM concentrations were positively correlated with smoking (r = 0.39) and lymph node metastasis (r = 0.37) (both P < 0.01). (3) NRCAM concentration was positively correlated with the clinical stage of SCLC, being significantly lower in stages I-II compared to stages III-IV (P < 0.01), and was remarkably lower in the non-metastatic group of SCLC relative to the metastatic group (P < 0.01). (4) Compared to the NSCLC group, ProGRP exhibited the largest area under the receiver operating characteristic curve (AUC) and the highest sensitivity for SCLC diagnosis, with values of 0.86 and 76 %, respectively. NRCAM had the highest specificity for SCLC diagnosis (94 %). Compared to the PN group, NRCAM exhibited a larger AUC (0.81) and higher sensitivity (74 %) for SCLC diagnosis. Conversely, NSE displayed a higher specificity for SCLC diagnosis (93 %). The combined diagnostic approach using NRCAM, NSE, and ProGRP yielded the largest AUC and the highest sensitivity, at 0.94 and 91 %, respectively. (5) Binary logistic regression analysis revealed that smoking and lymph node metastasis were potential risk factors influencing serum NRCAM levels.

NRCAM possess significant potential for diagnosing SCLC and distinguishing SCLC from NSCLC and PN. Moreover, the combination detection of NRCAM, NSE, and ProGRP may enhance diagnostic performance, offering a novel clinical strategy for SCLC.