The expression level of serum fibronectin in patients with non-small cell lung cancer and its clinical appli-cation value

WANG Qingbao; CHEN Shouhui; LIU Yating; ZHU Jun; ZHANG Boke

doi:10.3969/j.issn.1006-5725.2025.10.016

Abstract：Objective To investigate the expression levels of serum fibronectin(FN)in patients with non-small cell lung cancer(NSCLC)and evaluate its clinical diagnostic significance.Methods Firstly,the gene and tissue protein expression levels of FN in NSCLC were assessed using the TIMER2.0 database,GTEx database,and Human Protein Atlas(HPA)database.Secondly,from January 2021 to June 2023,a total of 154 patients with lung space-occupying lesions or shadows at the First Affiliated Hospital of Anhui University of Chinese Medicine were enrolled.Based on medical history,clinical manifestations,imaging tests,and pathological histological find-ings,these patients were categorized into two groups:81 patients with NSCLC and 73 patients with benign lung diseases.The serum concentration of FN was measured by immunoturbidimetry,while the serum levels of CEA,SCC,and CYFRA21-1 were determined using chemiluminescence.Results The bioinformatics analysis results demonstrated that the gene expression and tissue protein levels of FN were significantly reduced compared to normal tissues.In serological evaluations,serum FN concentrations in patients with advanced NSCLC(Stage Ⅲ-Ⅳ)and early-stage NSCLC(Stage Ⅰ-Ⅱ)(249.50 ng/mL and 305.00 ng/mL,respectively)were markedly lower than those observed in the benign lung disease group(429.16 ng/mL)(P<0.001).Univariate and multivariate logistic regression analyses indicated that serum FN could serve as a significant predictor for the presence of NSCLC.The area under the receiver operating characteristic curve(ROC)for serum FN in diagnosing early-stage NSCLC was 0.790,which outperformed CEA(0.618),SCC(0.653),and CYFRA21-1(0.601).The optimal critical concen-tration of serum FN for distinguishing early-stage NSCLC from benign diseases was determined to be 347.6 ng/mL,with a sensitivity of 71.93％,surpassing that of CEA(19.30％),SCC(12.28％),and CYFRA21-1(8.77％).Conclusion Serum FN is significantly downregulated in NSCLC and may serve as a potential biomarker for the early diagnosis of NSCLC.