CXCL4L1 May Help Differentiate Benign from Malignant Pulmonary Lesions and Predicts Prognosis of Patients with Lung Cancer

BACKGROUND: Lung cancer (LC) is the leading type of cancer worldwide, yet it’s challenging to detect early LC. Therefore, it is valuable to explore diagnostic biomarker that can distinguish malignant pulmonary lesions from benign diseases. The potential role of plate factor-4 variant (CXCL4L1) will be investigated in detecting early LC. METHODS: A consecutive of 174 patients with single pulmonary nodule and 50 healthy controls were enrolled. Serum CXCL4L1 expression level was evaluated using ELISA. Survival curves were generated to analyze survival outcomes. Receiver operating characteristic curves were used to calculate diagnostic accuracy. RESULTS: Serum CXCL4L1 was downregulated in patients with LC when compared with those with lung benign lesions (LBL) or healthy controls. Meanwhile, lower serum CXCL4L1 expression was associated with advanced TNM stage and lymph node metastasis. Furthermore, a low expression of CXCL4L1 resulted in worse survival outcomes in LC patients. Serum CXCL4L1 expression obtained an area under curve (AUC) of 0.81 (95% CI: 0.74–0.88), a sensitivity of 70.6%, and a specificity of 85.8% for discriminating patients with LC form patients with LBL. In addition, serum CXCL4L1 expression achieved an AUC of 0.82 (95% CI, 0.74–0.90), a sensitivity of 72.0%, and a specificity of 85.9% for distinguishing patients with LC form healthy controls. CONCLUSION: This study suggests that CXCL4L1 may prove to be a potential non-invasive diagnostic and prognostic biomarker for early LC patients.