Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2020; 8(10): 1916-1922
Published online May 26, 2020. doi: 10.12998/wjcc.v8.i10.1916
Serum von Willebrand factor for early diagnosis of lung adenocarcinoma in patients with type 2 diabetes mellitus
Ying-Yi Zhou, Xuan Du, Jia-Li Tang, Qiu-Ping Wang, Ke Chen, Bi-Min Shi
Ying-Yi Zhou, Xuan Du, Jia-Li Tang, Qiu-Ping Wang, Bi-Min Shi, Department of Endocrinology, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Ke Chen, Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Author contributions: Zhou YY and Du X contributed equally to this study and should be regarded as the co-first authors; Shi BM and Chen K should be regarded as the co-corresponding authors; Shi BM and Chen K conceived the study; Zhou YY, Chen K, Wang QP, and Tang JL assembled the data; Zhou YY and Du X analyzed the data, and contributed to the discussion of the article; Shi BM reviewed and edited the article; all authors read and approved the submitted manuscript.
Institutional review board statement: All procedures were performed in accordance with the ethical standards of the Medical Ethics Committee of The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (2019-061) and with the Helsinki Declaration of 1975, as revised in 2000 (5).
Informed consent statement: Informed consent was obtained from all patients and volunteers.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: The data used to support the findings of this study are available from the corresponding author upon request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Bi-Min Shi, MD, Academic Research, Department of Endocrinology, The First Affiliated Hospital of Soochow University, No. 188, Shizi Road, Suzhou 215000, Jiangsu Province, China. gtmake144523@163.com
Received: February 10, 2020
Peer-review started: February 10, 2020
First decision: March 27, 2020
Revised: April 18, 2020
Accepted: April 24, 2020
Article in press: April 24, 2020
Published online: May 26, 2020
Processing time: 105 Days and 0.7 Hours
Abstract
BACKGROUND

The elevation of plasma von Willebrand factor (vWF) has been proposed to be a predictor of lung cancer. Type 2 diabetes mellitus (T2DM) causes endothelial activation, resulting in the secretion of vWF. However, the role of vWF in patients with T2DM complicated with lung cancer remains unclear.

AIM

To investigate the clinical value of serum vWF as a tumor marker in patients with T2DM combined with lung adenocarcinoma in situ (AIS).

METHODS

This study enrolled 43 patients with T2DM combined with lung AIS (T2DM + AIS group), 43 patients with T2DM alone (T2DM group), 43 patients with lung AIS alone (AIS group), and 43 healthy volunteers (control group). The serum levels of vWF, insulin-like growth factor 1, and insulin-like growth factor binding protein 3 were determined. Multiple linear stepwise regression was performed to determine the correlations among variables.

RESULTS

Serum concentration of vWF in the T2DM + AIS group was significantly higher than those in the T2DM, AIS, and control groups (P < 0.05). Serum vWF levels in the T2DM and AIS groups were significantly higher than that in the control group (P < 0.05). There was no significant difference in serum vWF level between the T2DM and AIS groups. In the T2DM + AIS group, serum vWF was independently associated and positively correlated with serum levels of insulin-like growth factor 1 and insulin-like growth factor binding protein 3 (P < 0.05).

CONCLUSION

Serum vWF level may represent a novel biomarker for the early diagnosis of lung AIS.

Keywords: Type 2 diabetes mellitus, Adenocarcinoma in situ, von Willebrand factor, Early diagnosis, Correlation

Core tip: Previous evidence has indicated an increased cancer risk among patients with type 2 diabetes mellitus (T2DM). However, early diagnosis of lung adenocarcinoma in situ (AIS) in T2DM patients is difficult, resulting in a lost opportunity for curative-intent surgery in almost 70%-80% of lung cancer patients. This study revealed that serum levels of von Willebrand factor in patients with T2DM combined with lung AIS were significantly higher than those in patients with T2DM, and thus, can be used to screen lung AIS in T2DM patients. Thus, monitoring serum von Willebrand factor might promote the early diagnosis of lung AIS in T2DM patients.