Study On The Clinical Value Of Tumor-associated Autoantibody Detection In The Diagnosis Of Lung Cancer

Objective:To explore the clinical diagnostic value of lung cancer-related autoantibodies in newly diagnosed lung cancer patients.Methods:Selected 383 patients in Tongji Hospital of Huazhong University of Science and Technology from January 2020 to December 2020 as the research objects.According to pathological diagnosis and imaging diagnosis,the above-mentioned patients were divided into lung cancer group and benign lung disease group,and 247 healthy people who were treated at the physical examination center of our hospital during the same period were set as healthy people.Enzyme-linked immunosorbent assay(ELISA)was used to detect the concentration of 7 lung cancer autoantibodies(P53,SOX2,GAGE7,PGP9.5,MAGE A1,GBU4-5,CAGE)in the above subjects,chemiluminescence method was used to detect the concentration of 5 serum tumor markers(CEA,NSE,CYFRA21-1,SCC,pro GRP)of the above subjects.Further study the relationship between the concentration of seven lung cancer autoantibodies in the serum of lung cancer patients and TNM staging,pathological type,lymph node metastasis,distant metastasis,tumor size,etc.Analyze the sensitivity and specificity of 7 lung cancer autoantibodies alone and in combination in detecting lung cancer,and analyze the value of 7 lung cancer autoantibodies and serum tumor markers in the diagnosis of lung cancer.Result:1.The expression levels of each individual item of lung cancer autoantibodies are different among the three groups,and the difference is statistically significant.2.Comparison of the positive rate of lung cancer autoantibody single item and7-item autoantibody combined interpretation(7-TAAbs)in each group found that:the positive rate of autoantibody PGP9.5 and MAGE A1 was not statistically different between each group(χ~2=3.956,p=0.138,χ~2=2.864,p=0.239,all p>0.05),the positive rates of other autoantibodies were statistically different among the groups(p<0.05).7-TAAbs combined interpretation has statistically significant differences among the three groups,after pairwise comparison,there is a statistically significant difference in the positive rate between the lung cancer group and the benign disease group(χ~2=62.265,p=0.000),the difference in the positive rate between the lung cancer group and the healthy group was statistically significant(χ~2=138.195,p=0.000),there was no statistically significant difference in the positive rate between the benign disease group and the healthy group(χ~2=1.647,p=0.199),the positive rate of 7-TAAbs combined interpretation in lung cancer group was higher than that in healthy people and benign lung disease group.3.The expression levels of autoantibodies P53,PGP9.5,SOX2,GAGE7,GBU4-5,MAGE A1 and CAGE between the early lung cancer group and the healthy group are statistically significant(Z values are 5.732,7.235,3.057,3.856,7.870,13.427 and 16.470 respectively;all p<0.05);There was no statistically significant difference in the positive rates of PGP9.5 and MAGE A1 between the early lung cancer group and the healthy group(p values were0.745 and 0.358,respectively);The positive rate of P53,SOX2,GAGE7,GBU4-5,CAGE and 7-TAABs in the early lung cancer group is higher than that in the healthy group,and the difference is statistically significant(χ~2 are8.025,13.797,29.130,18.908,25.601 and 107.844,respectively;all p<0.05).4.The positive rate of 7-TAAbs is statistically significant in different clinical stages,pathological types,lymph node metastasis,remote metastasis,and tumor size.The positive rate of advanced lung cancer>the positive rate of early lung cancer,squamous cell carcinoma positive rate>adenocarcinoma positive rate,positive rate of lymph node metastasis>positive rate of no lymph node metastasis,positive rate of distant metastasis>positive rate of no distant metastasis,"tumor size>3cm group"positive rate>"tumor size≤3cm group"positive rate.5.The individual autoantibodies and traditional tumor markers showed low sensitivity and high specificity in the diagnosis of lung cancer with healthy people and people with benign lung diseases as the control group;7-TAAbs can increase the sensitivity of the diagnostic test(58.55%)but reduce the specificity(89.30%);7-TAAbs has higher sensitivity(58.55%vs 54.18%)and lower AUC compared with traditional tumor marker combined detection(Sensitivity:58.55%vs 54.18%,AUC:0.747 vs 0.761;both p>0.05);The sensitivity of the combined detection of 7-TAAbs+traditional tumor markers is 66.91%,the specificity is 90.42,and the AUC is 0.812(95%CI:0.779-0.841).The sensitivity and AUC of the combined detection of7-TAAbs+traditional tumor markers are higher than 7-Combined detection of TAAbs or traditional tumor markers(Sensitivity:66.91%vs 58.55%,54.18%,AUC:0.812 vs 0.747,0.716;both p<0.05).Conclusion:1.The elevated serum expression level of single TAAbs in patients with early lung cancer indicates that it has certain application value in early lung cancer screening.2.The diagnostic efficiency of combined detection of 7-TAAbs is higher than that of single TAAbs detection,combined with detection of traditional tumor markers can further improve the diagnostic efficiency of lung cancer.3.The positive rate of combined detection of 7-TAAbs is statistically different in different clinical stages and different pathological types of lung cancer,indicating that it has certain application value in distinguishing clinical stages and pathological types of lung cancer.