Calprotectin as a Potential Biomarker for Inflammation in Lung Cancer Patients

Background/Objectives: Calprotectin (CLP), a calcium-binding protein complex released predominantly from neutrophils and monocytes, plays a key role in the inflammatory response. Increased levels of CLP have been reported in various inflammatory and malignant conditions. This study aimed to evaluate serum CLP concentrations and their associations with hematological and biochemical parameters in patients with lung cancer. Methods: This prospective observational study included newly diagnosed lung cancer patients and a healthy control group. Demographic data, routine laboratory parameters, CLP levels, and inflammatory indices including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV) were recorded. Comparisons were made between groups and across tumor molecular profile, cancer stages, and metastasis status. Correlation and ROC analyses were performed. Results: Serum CLP levels were significantly higher in the lung cancer group compared with healthy controls (p < 0.001). Among molecular subgroups, patients with positive molecular testing had significantly elevated CLP levels compared with negative and untested groups (p = 0.025). CLP did not differ significantly across cancer stages or metastasis status (p > 0.05). CLP showed a positive correlation with the SIRI (r = 0.323; p = 0.004) and PIV (r = 0.395; p < 0.001). ROC analysis revealed that CLP demonstrated good diagnostic performance for lung cancer, with an AUC of 0.930 (95% CI: 0.849-0.976), sensitivity of 79.5%, and specificity of 92.3%. Among inflammatory indices, PIV (AUC = 0.863) and SIRI (AUC = 0.810) also showed high diagnostic accuracy. Conclusions: CLP levels are significantly elevated in lung cancer and show strong discriminative ability, outperforming commonly used inflammatory indices. Although CLP is not specific to lung cancer, it may serve as a supportive, noninvasive biomarker reflecting inflammatory burden when interpreted alongside clinical evaluation, imaging findings, and other laboratory parameters.