Cancer Medicine, 2019. 8(12), 5507-5514, DOI: https://doi.org/10.1002/cam4.2457

The diagnostic value of serum gastrokine 1 (GKN1) protein in gastric cancer

Won Sang Park, Jung Hwan Yoon;Yong Gyu Park;Suk Woo Nam

Abstract

Early detection of cancer provides effective treatment and saves lives. The objectiveof this study was to determine whether serum gastrokine 1 (GKN1) protein is agastric cancer‐specific diagnostic biomarker. The serum concentration of GKN1 inhealthy individuals (median: 6.34 ng/μL, interquartile range (IQR): 5.66‐7.54 ng/μL)was significantly higher compared with the levels in gastric cancer patients (median:3.48 ng/μL, IQR: 2.90‐4.11 ng/μL; P < .0001). At the optimum cutoff (4.94 ng/μL) of serum GKN1 protein, the sensitivity and specificity were 91.2% and 96.0%,respectively, for gastric cancer. Using serum GKN1 protein as the diagnostic reference,the ROC curve showed a satisfactory diagnostic efficacy with an AUC valueof 0.9954 (95% CI 0.9919‐0.9988) and Youden index of 0.8740. In addition, thediagnostic accuracy of the serum GKN1 protein at the optimum cutoff was 0.9675.Interestingly, serum GKN1 concentrations in patients with advanced gastric cancer(AGC; median: 3.11 ng/μL, IQR: 2.72‐3.72 ng/μL) were lower than in patients withearly gastric cancer (EGC; median: 4.31 ng/μL, IQR: 3.88‐4.88 ng/μL). The diagnosticaccuracies at the optimum serum GKN1 cutoff were 0.8912 and 0.9589 forEGC and AGC, respectively. Furthermore, the serum GKN1 concentrations robustlydiscriminated the patients with gastric cancer from the patients with colorectal, liver,lung, breast, pancreatic, ovary, and prostatic cancers with AUC values greater than0.94. These data suggest that serum GKN1 is a promising and highly specific diagnosticbiomarker for the prompt detection of early and advanced gastric cancers.

• DOI: https://doi.org/10.1002/cam4.2457
• ISBN or ISSN: 2045-7634

• 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
• This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.