Increased level of serum leucine-rich-alpha-2-glycoprotein 1 in patients with clear cell renal cell carcinoma

Q: Why is early detection of clear cell renal cell carcinoma challenging?

Useful serum markers for ccRCC are currently unavailable, making early detection difficult. Diagnosis relies mainly on imaging tests, which can require repeated CT examinations during treatment.

Q: How was LRG1 measured and in which patients?

Serum leucine-rich-alpha-2-glycoprotein 1 (LRG1) was measured using an enzyme-linked immunosorbent assay. The study included 64 patients with ccRCC, 22 with non-ccRCC, and 63 patients without cancer.

Q: What factors predicted higher serum LRG1 levels in ccRCC?

C-reactive protein (CRP), anemia, hypercalcemia, and tumor grade were reported as independent predictors of serum LRG1 levels in ccRCC.

Q: How accurate is serum LRG1 for distinguishing ccRCC from non-ccRCC?

Diagnostic performance using the receiver operating characteristic curve showed area under the curve values of 0.73 for ccRCC versus non-cancer/non-ccRCC and 0.91 for ccRCC versus non-ccRCC, indicating excellent accuracy.

Sep 21, 2026

Uploaded by Ava Thompson

Background: Clear cell renal cell carcinoma (ccRCC) lacks useful serum markers, so early detection is difficult and diagnosis relies heavily on imaging, while repeated CT exposures increase radiation concerns. Therapeutic response differs between ccRCC and non-clear cell RCC, requiring accurate differentiation. This study aimed to identify a novel serum marker, focusing on LRG1, previously linked to angiogenesis and elevated in multiple cancers.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Background

Study aims

Methods

Patient groups and assay

Results

Serum LRG1 levels

Predictors and diagnostic performance

Conclusions

Clinical implications

Nakanishi et al. BMC Urology (2024) 24:94 [https://doi.org/10.1186/s12894-024-01481-0](https://doi.org/10.1186/s12894-024-01481-0) BMC Urology RESEARCH Open Access Increased level of serum leucine-rich-alpha-2-glycoprotein 1 in patients with clear cell renal cell carcinoma Shotaro Nakanishi 1*, Masato Goya2, Tetsuji Suda 1, Tomoko Yonamine 1, Ai Sugawa 1 and Seiichi Saito 1 Abstract Background Currently, no useful serum markers exist for clear cell renal cell carcinoma (ccRCC), making early detection challenging as diagnosis relies solely on imaging tests. Radiation exposure is also a concern due to multiple required CT examinations during treatment. Renal cell carcinoma (RCC) histological types include ccRCCand non-clear cell RCC (non-ccRCC); however, treatment response to medications varies which necessitates accurate differentiation between the two. Therefore, we aimed to identify a novel serum marker of RCC. Increased LRG1 expression in the serum has been demonstrated in multiple cancer types. However, the expression of LRG1 expression in the serum and cancer tissues of patients with RCC has not been reported. Since ccRCC is a hypervascular tumor and LRG1 is capable of accelerating angiogenesis, we hypothesized that the LRG1 levels may be related to ccRCC. Therefore, we examined LRG1 expression in sera from patients with RCC. Methods Using an enzyme-linked immunosorbent assay, serum levels of leucine-rich-alpha-2-glycoprotein 1 (LRG1) were measured in 64 patients with ccRCC and 22 patients non-ccRCC who underwent radical or partial nephrectomy, as well as in 63 patients without cancer. Results Median values of serum LRG1 and their inter-quartile ranges were 63.2 (42 .8–94. 2) µg/mL in ccRCC, 23.4 (17 .7–29. 6) µg/mL in non-ccRCC, and 36.0 (23 .7–56. 7) µg/mL in patients without cancer, respectively (ccRCC vs. non-ccRCC or patients without cancer: P < 0. 001) . C-reactive protein (CRP) levels (P = 0 . 002), anemia (P = 0 . 037), hypercalcemia (P = 0 . 023), and grade (P = 0 . 031) were independent predictors of serum LRG1 levels in ccRCC. To assess diagnostic performance, the area under the receiver operating characteristic curve of serum LRG1 was utilized to differentiate ccRCC from non-cancer and non-ccRCC, with values of 0.73 (95% CI, 0 .64–0. 82) and 0.91 (95% CI, 0.82–0. 96), respectively. Conclusions LRG1 served as a serum marker associated with inflammation, indicated by CRP, anemia, hypercalcemia, and malignant potential in ccRCC. Clinically, serum LRG1 levels may assist in differentiating ccRCC from non-ccRCC with excellent diagnostic accuracy. Keywords LRG1, Leucine-rich-alpha-2-glycoprotein 1, Clear cell renal cell carcinoma, Serum marker *Correspondence: Shotaro Nakanishi [shotaro@med. u-ryukyu.ac.jp](shotaro@med. u-ryukyu.ac.jp) 1Department of Urology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara, Nishihara 903-0215, Okinawa, Japan 2ChubuTokusyukai Hospital, Kitanakagusuku 801 higa, 901-2392, Okinawa, Japan © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/l](http://creativecommons.org/l)icenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ([http://

FAQs

Why is early detection of clear cell renal cell carcinoma challenging?

Useful serum markers for ccRCC are currently unavailable, making early detection difficult. Diagnosis relies mainly on imaging tests, which can require repeated CT examinations during treatment.

How was LRG1 measured and in which patients?

Serum leucine-rich-alpha-2-glycoprotein 1 (LRG1) was measured using an enzyme-linked immunosorbent assay. The study included 64 patients with ccRCC, 22 with non-ccRCC, and 63 patients without cancer.

What factors predicted higher serum LRG1 levels in ccRCC?

C-reactive protein (CRP), anemia, hypercalcemia, and tumor grade were reported as independent predictors of serum LRG1 levels in ccRCC.

How accurate is serum LRG1 for distinguishing ccRCC from non-ccRCC?

Diagnostic performance using the receiver operating characteristic curve showed area under the curve values of 0.73 for ccRCC versus non-cancer/non-ccRCC and 0.91 for ccRCC versus non-ccRCC, indicating excellent accuracy.

Sep 21, 2026

Uploaded by Ava Thompson