Diagnostic value of endothelial-specific molecule-1 levels in patients with bone tumors
Eyup Senocak, Nurinnisa Ozturk, Adem Keskin, Umit Aygun, Ibrahim Dag
Background: Endothelial-specific molecule-1 (ESM-1), also known as endocan, is a circulating proteoglycan that may be involved in tumor-associated endothelial activation and angiogenesis. This study evaluated its diagnostic value in detecting bone tumors and distinguishing benign from malignant lesions. Methods: This cross-sectional study included 60 patients with bone tumors and 30 healthy controls. Serum ESM-1 levels were measured using an enzyme-linked immunosorbent assay (ELISA). Statistical analyses included logistic regression, receiver operating characteristic (ROC) curve analysis, and correlation testing. Results: Serum ESM-1 levels were significantly higher in patients with bone tumors than in healthy controls. The area under the ROC curve was 0.895, with 78.3% sensitivity and 80.0% specificity at a cut-off of 138.94 ng/L. ESM-1 levels were also significantly higher in patients with malignant tumors than in those with benign tumors. The subgroup analysis showed excellent discrimination of malignant tumors in this sample, although the findings require external validation. Conclusion: Serum ESM-1 may be a promising minimally invasive biomarker for the assessment of bone tumors and their malignant potential. Larger multicenter studies are necessary to confirm its diagnostic accuracy and establish clinically applicable thresholds.