Lab Med Online.  2016 Jan;6(1):25-30. 10.3343/lmo.2016.6.1.25.

Usefulness of Serum Thymidine Kinase 1 as a Biomarker for Aggressive Clinical Behavior in B-cell Lymphoma

• Kim H
• Kang HJ
• Lee JK
• Hong YJ
• Hong SI
• Chang YH

• KMID: 2312288
• DOI: http://doi.org/10.3343/lmo.2016.6.1.25

Abstract

BACKGROUND
The cell cycle-dependent enzyme thymidine kinase 1 (TK1) is known to increase during cancer cell proliferation and has been reported as a prognostic marker for various hematologic malignancies and solid tumors. This study aimed to determine the reference interval in Korean healthy controls and to evaluate the usefulness of TK1 as a biomarker for aggressive clinical behavior in B-cell lymphoma patients.
METHODS
We enrolled 72 previously untreated patients with B-cell lymphoma and 143 healthy controls. Serum TK1 levels were measured by chemiluminescence immunoassay (Liaison(R), DiaSorin, USA). We established the reference intervals in healthy controls. The diagnostic performance of serum TK1 was studied using receiver operating characteristic (ROC) analysis, and the correlation between the cutoff level for serum TK1 and clinical characteristics of B-cell lymphoma was evaluated.
RESULTS
The reference range (95th percentile) of serum TK1 in healthy controls was 5.4-21.8 U/L. There was a clear difference in TK1 levels between patients with B-cell lymphoma and healthy controls (40.6+/-68.5 vs. 11.8+/-4.4 U/L, P<0.001). The area under the curve of serum TK1 for the diagnosis of B-cell lymphoma was 0.73 (cutoff, 15.2 U/L; sensitivity, 59.7%; specificity, 83.2%). An increased TK1 level (> or =15.2 U/L) correlated with the advanced clinical stage (P<0.001), bone marrow involvement (P=0.013), international prognostic index score (P=0.001), lactate dehydrogenase level (P=0.001), low Hb level (<12 g/dL) (P=0.028), and lymphocyte count (P=0.023).
CONCLUSIONS
The serum TK1 level could serve as a useful biomarker for aggressive clinical behavior in B-cell lymphoma patients.

Keyword

Thymidine kinase 1; B-cell lymphoma; Serum biomarker

MeSH Terms

B-Lymphocytes*
Bone Marrow
Cell Proliferation
Diagnosis
Hematologic Neoplasms
Humans
Immunoassay
L-Lactate Dehydrogenase
Luminescence
Lymphocyte Count
Lymphoma, B-Cell*
Reference Values
ROC Curve
Sensitivity and Specificity
Thymidine Kinase*
Thymidine*
L-Lactate Dehydrogenase
Thymidine
Thymidine Kinase

Figure

• 

  Fig. 1 Comparison of serum thymidine kinase 1 (TK1) levels between healthy controls and patients with B-cell lymphoma. The upper and lower ends of the boxes and the box inner lines correspond to the 3rd and 1st quartiles and median values, respectively. Error bars denote minimum and maximum values, and circles and stars indicate outlier values.

• 

  Fig. 2 Receiver operating characteristic (ROC) curve of serum thymidine kinase 1 (TK1) levels in patients with B-cell lymphoma. The area under the curve (AUC) of serum TK1 for the diagnosis of B-cell lymphoma was 0.73 (cutoff, 15.2 U/L) with its 95% confidence interval.

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