Table 3.
Performance of the 4-biomarker panel (with or without adjustment) on detection of lung cancer in both training and validation cohorts.
| Training |
Validation |
|||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AUC (95% CI) | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Positive LR | Negative LR | AUC (95% CI) | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Positive LR | Negative LR | |
| All LC vs HC | ||||||||||||||
| 4-marker | 0.86 (0.83–0.88) | 69.98 | 87.04 | 90.7 | 61.6 | 5.40 | 0.34 | 0.87 (0.83–0.89) | 69.35 | 87.23 | 83.8 | 74.9 | 5.43 | 0.35 |
| Adj 4-markera | 0.90 (0.87–0.93) | 88.16 | 80.43 | 93.7 | 67.3 | 4.51 | 0.15 | 0.89 (0.86–0.93) | 85.12 | 78.91 | 87.1 | 75.9 | 4.04 | 0.19 |
| CEA | 0.76 (0.73–0.79) | 57.83 | 86.38 | 88.5 | 53.2 | 4.25 | 0.49 | 0.80 (0.76–0.83) | 55.17 | 94.16 | 90.0 | 68.8 | 9.45 | 0.48 |
| 4-marker + CEA | 0.91 (0.89–0.93) | 81.95 | 83.72 | 90.1 | 72.0 | 5.03 | 0.22 | 0.93 (0.91–0.95) | 80.84 | 90.51 | 89.0 | 83.2 | 8.52 | 0.21 |
| SCLC vs HC | ||||||||||||||
| 4-marker | 0.86 (0.82–0.89) | 69.44 | 87.04 | 39.1 | 96.0 | 5.36 | 0.35 | 0.85 (0.80–0.89) | 73.68 | 87.23 | 28.6 | 98.0 | 5.77 | 0.30 |
| Adj 4-markera | 0.92 (0.87–0.97) | 87.50 | 85.21 | 52.8 | 97.3 | 5.92 | 0.15 | 0.88 (0.79–0.96) | 86.67 | 72.67 | 22.8 | 98.3 | 3.17 | 0.18 |
| CEA | 0.74 (0.69–0.79) | 58.33 | 86.38 | 33.9 | 94.5 | 4.28 | 0.48 | 0.67 (0.61–0.72) | 42.11 | 94.16 | 33.3 | 95.9 | 7.21 | 0.61 |
| 4-marker + CEA | 0.88 (0.84–0.91) | 80.56 | 83.72 | 37.2 | 97.3 | 4.95 | 0.23 | 0.90 (0.86–0.93) | 63.16 | 90.51 | 31.6 | 97.3 | 6.66 | 0.41 |
| NSCLC vs HC | ||||||||||||||
| 4-marker | 0.85 (0.82–0.88) | 68.60 | 87.04 | 85.2 | 71.8 | 5.29 | 0.36 | 0.86 (0.83–0.90) | 71.43 | 87.23 | 74.1 | 85.7 | 5.59 | 0.33 |
| Adj 4-markera | 0.90 (0.87–0.93) | 87.54 | 82.84 | 89.7 | 79.5 | 5.10 | 0.15 | 0.90 (0.86–0.94) | 88.33 | 78.26 | 75.2 | 90.0 | 4.06 | 0.15 |
| CEA | 0.77 (0.73–0.80) | 57.62 | 86.38 | 82.2 | 65.2 | 4.23 | 0.49 | 0.83 (0.79–0.87) | 59.29 | 94.16 | 83.8 | 81.9 | 10.15 | 0.43 |
| 4-marker + CEA | 0.91 (0.88–0.93) | 81.40 | 83.72 | 84.5 | 80.5 | 5.00 | 0.22 | 0.94 (0.91–0.96) | 84.29 | 90.51 | 81.9 | 91.9 | 8.88 | 0.17 |
| Stage I & II LC vs HC | ||||||||||||||
| 4-marker | 0.84 (0.81–0.88) | 62.61 | 87.04 | 64.9 | 85.9 | 4.83 | 0.43 | 0.84 (0.80–0.88) | 64.29 | 87.23 | 50.7 | 92.3 | 5.03 | 0.41 |
| Adj 4-markera | 0.91 (0.87–0.94) | 83.17 | 86.98 | 79.2 | 89.6 | 6.39 | 0.19 | 0.88 (0.83–0.94) | 76.6 | 86.3 | 62.1 | 92.7 | 5.61 | 0.27 |
| CEA | 0.69 (0.64–0.73) | 42.61 | 86.38 | 54.4 | 79.8 | 3.13 | 0.66 | 0.76 (0.71–0.81) | 44.64 | 94.16 | 61.0 | 89.3 | 7.65 | 0.59 |
| 4-marker + CEA | 0.87 (0.84–0.90) | 73.04 | 83.72 | 63.2 | 89.0 | 4.49 | 0.32 | 0.93 (0.90–0.95) | 75.00 | 90.51 | 61.8 | 94.7 | 7.90 | 0.28 |
| Stage III & IV LC vs HC | ||||||||||||||
| 4-marker | 0.87 (0.84–0.89) | 72.88 | 87.04 | 87.2 | 72.5 | 5.62 | 0.31 | 0.87 (0.84–0.90) | 69.66 | 87.23 | 78.0 | 81.6 | 5.45 | 0.35 |
| Adj 4-markera | 0.91 (0.88–0.94) | 84.82 | 86.98 | 92.1 | 76.2 | 6.52 | 0.17 | 0.91 (0.88–0.94) | 86.99 | 80.75 | 80.4 | 87.2 | 4.52 | 0.16 |
| CEA | 0.78 (0.74–0.81) | 60.55 | 86.38 | 84.4 | 64.4 | 4.45 | 0.46 | 0.80 (0.76–0.84) | 55.62 | 94.16 | 86.1 | 76.6 | 9.52 | 0.47 |
| 4-marker + CEA | 0.92 (0.90–0.94) | 85.21 | 83.72 | 86.4 | 82.4 | 5.23 | 0.18 | 0.93 (0.90–0.95) | 81.46 | 90.51 | 84.8 | 88.3 | 8.58 | 0.20 |
HC = healthy control. LC = lung cancer. SCLC = small cell lung cancer. NSCLC = non-small cell lung cancer.
a
Model corrected by sex (Male, Female), age at enrollment (continuous), smoking status (Never, Former, Current) and the 4-marker panel (continuous).