Circulating progastrin-releasing peptide in the diagnosis of Small Cell Lung Cancer (SCLC) and in therapeutic monitoring


  • Vittoria Barchiesi Department “Campania Centro”, A.O.R.N. “Antonio Cardarelli”, Napoli - Italy
  • Vittorio Simeon Medical Statistics Unit, University of Campania “Luigi Vanvitelli”, Napoli - Italy
  • Claudia Sandomenico Thoracic Medical Oncology Unit, Istituto Nazionale Tumori IRCCS, “Fondazione G.Pascale”, Napoli - Italy
  • Monica Cantile Pathology Unit, Istituto Nazionale Tumori IRCCS, “Fondazione G.Pascale”, Napoli - Italy
  • Dionigio Cerasuolo Laboratory Medicine Unit, Istituto Nazionale Tumori IRCCS, “Fondazione G.Pascale”, Napoli - Italy
  • Paolo Chiodini Medical Statistics Unit, University of Campania “Luigi Vanvitelli”, Napoli - Italy
  • Alessandro Morabito Thoracic Medical Oncology Unit, Istituto Nazionale Tumori IRCCS, “Fondazione G.Pascale”, Napoli - Italy
  • Ernesta Cavalcanti Laboratory Medicine Unit, Istituto Nazionale Tumori IRCCS, “Fondazione G.Pascale”, Napoli - Italy



Lung cancer, proGRP, Serum biomarker


Introduction: Progastrin-releasing peptide (proGRP), a precursor of GRP, has been recently reported as a putative circulating biomarker for differential diagnosis between non–small cell lung cancer (NSCLC) and SCLC. We evaluated the diagnostic effectiveness of proGRP to differentiate patients with NSCLC and SCLC and the usefulness of combined measurement of proGRP and neuron-specific enolase (NSE) for diagnosing SCLC.

Methods: Serum proGRP, NSE, cytokeratin 19 fragment 21-1 (CYFRA 21.1), squamous cell carcinoma antigen (SCC Ag) and carcinoembryonic antigen (CEA) were prospectively collected and measured in patients with a new diagnosis of lung cancer. Serum proGRP was also measured in healthy subjects. The serum proGRP, NSE, CYFRA 21.1 and CEA concentrations were determined by an electrochemiluminescence immunoassay and the serum SCC Ag concentration was determined by an automated immunofluorescence assay. Differences between proGRP and NSE in patients with SCLC and NSCLC were evaluated and compared using Mann-Whitney test.

Results: A total of 77 patients affected by SCLC (n = 17) and NSCLC (n = 60) were enrolled in the present study. Moreover, 50 cases of healthy subjects were analyzed for proGRP. SCLC patients showed a significantly higher proGRP (1,484 pg/mL; range 168-3,777) levels compared to NSCLC patients (45 pg/mL; range 31.7-60.6), p<0.0001. In healthy subjects the median proGRP level was 36.1 (28.8-43.5) pg/mL, significantly lower than SCLC patients. ProGRP showed a higher specificity when compared to NSE, with a difference in proportion of 47.5% (95% confidence interval 32.5% to 62.5%, p<0.001). Serial measurements of proGRP in SCLC patients showed a decrease in responsive chemotherapy patients.


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How to Cite

Barchiesi V, Simeon V, Sandomenico C, Cantile M, Cerasuolo D, Chiodini P, Morabito A, Cavalcanti E. Circulating progastrin-releasing peptide in the diagnosis of Small Cell Lung Cancer (SCLC) and in therapeutic monitoring. J Circ Biomark [Internet]. 2021 Jul. 7 [cited 2021 Oct. 24];10:9-13. Available from:



Original research article