Evidence map›Paper›PMID 38941006›Full record

ArticleInflammation2025

Plasma H3Cit-DNA Discriminates Between Cancer and Inflammation in a Cohort of Patients with Unspecific Cancer Symptoms.

Fredrika Wannberg, Viktoria Hjalmar, Henry Ng, Caroline Johansson, Fay Probert, Mia Phillipson, Mikael Åberg, Max Gordon, Nigel Mackman, Axel Rosell and 1 more

Abstract read
In one paragraph

Article in Inflammation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Fredrika WannbergDepartment of Clinical Sciences, Division of Internal Medicine, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Viktoria HjalmarDepartment of Clinical Sciences, Division of Internal Medicine, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Henry NgDepartment of Clinical Sciences, Division of Internal Medicine, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Caroline JohanssonDivision of Specialist Medical Care, Danderyd Hospital, Diagnostic Center, Stockholm, Sweden.
Fay ProbertDepartment of Chemistry, University of Oxford, Oxford, UK.
Mia PhillipsonDepartment of Medical Cell Biology, SciLifeLab, Uppsala University, Uppsala, Sweden.
Mikael ÅbergDepartment of Medical Sciences, Clinical Chemistry and SciLifeLab Affinity Proteomics, Uppsala University, Uppsala, Sweden.
Max GordonDivision of Internal Medicine, Department of Clinical Sciences, Division of Orthopedics, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Nigel MackmanDivision of Hematology, Department of Medicine, UNC Blood Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Axel Rosell *Department of Clinical Sciences, Division of Internal Medicine, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
Charlotte ThålinDepartment of Clinical Sciences, Division of Internal Medicine, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden. charlotte.thalin@ki.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cancer detection is challenging, especially in patients with unspecific cancer symptoms. Biomarkers could identify patients at high risk of cancer. Prior studies indicate that neutrophil extracellular traps (NETs) are associated with cancer, but also with autoimmune and infectious diseases. The objective of this prospective study was to investigate markers associated with NET formation (nucleosomal citrullinated histone 3 [H3Cit-DNA], cell free DNA [cfDNA] and neutrophil elastase [NE]), and c-reactive protein (CRP) in patients with unspecific cancer symptoms, such as fatigue, weight loss or radiological sign of malignancy without an apparent primary tumor, referred to the Diagnostic Center at Danderyd Hospital in Sweden. Blood samples were drawn on admission, before cancer diagnosis. Out of 475 patients, 160 (34%) were diagnosed with cancer, 56 (12%) with autoimmune disease, 32 (7%) with infectious disease, 71 (15%) with other diseases and 156 (33%) received no diagnosis. H3Cit-DNA, cfDNA, NE and CRP were significantly higher in patients with cancer compared to patients without cancer (p < 0.0001, p < 0.0001, p = 0.004, and p = 0.0002 respectively). H3Cit-DNA, but not cfDNA, NE or CRP, was significantly elevated in patients with cancer compared to patients with autoimmune disease (p = 0.0001). H3Cit-DNA, cfDNA, NE or CRP did not differ between cancer and infectious disease. In conclusion, H3Cit-DNA is elevated in patients diagnosed with cancer compared to non-cancer patients with the same symptomatology. Further studies should evaluate if H3Cit-DNA could aid in selecting patients that would benefit the most from a rapid cancer diagnostic work-up.

Indexed as

Biomarkers, TumorDNAHistonesInflammationNeoplasmsAdultAgedCell-Free Nucleic AcidsCohort StudiesC-Reactive ProteinDiagnosis, DifferentialExtracellular TrapsFemaleHumansLeukocyte ElastaseMaleBiomarkers, TumorCell-Free Nucleic AcidsC-Reactive ProteinDNAHistonesLeukocyte ElastaseBiomarkersHistonesNeoplasmsPlasma

Identifiers

PMID38941006
PMCPMC12053196

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.