The Diagnostic Value Of Seven Autoantibodies In Lung Cancer

Objective To explore the diagnostic value of seven autoantibodies(7-TAAbs:p53,GAGE7,PGP9.5,CAGE,MAGEA1,SOX2,GBU4.5)in lung cancer,and to analyze the relationship between the expression of seven autoantibodies and different pathological types,clinical stages and lesion size.To evaluate the diagnostic efficacy of seven autoantibodies combined with tumor markers and seven autoantibodies combined with chest thin layer CT in the diagnosis of early lung cancer.Methods According to the study criteria,168 patients were selected from the General Hospital of Ningxia Medical University from October 2019 to December 2020(all of them were diagnosed by pathological biopsy).There were 116 cases of lung cancer(lung cancer group)and 52 cases of pulmonary benign lesions(control group).The expression levels of seven autoantibodies in the serum of all patients were detected by enzyme linked immunosorbent assay(ELISA).The concentrations and positive rates of seven autoantibodies in each group were compared.The diagnostic value of seven autoantibodies and combined tumor markers CEA,NSE and CYFRA21-1 in lung cancer and early lung cancer was analyzed by receiver operating characteristic(ROC)curve.To discuss the relationship between the expression level of seven autoantibodies and different pathological types,clinical stages and lesion size.To evaluate the diagnostic efficacy of seven autoantibodies combined with tumor markers and seven autoantibodies combined with chest thin layer CT in the diagnosis of early lung cancer.Results there was no significant difference in the positive rate of seven autoantibodies in age,sex,smoking history and focus location in patients with lung cancer(P > 0.05).The concentrations of p53,SOX2,GAGE7,MAGEA1,CAGE in patients with lung cancer were significantly higher than those in patients with benign pulmonary diseases,and the positive rate of combined detection of seven autoantibodies in patients with lung cancer was significantly higher than that in patients with benign pulmonary diseases.In lung cancer group,the area under the ROC curve(AUC)of seven autoantibodies were all greater than 0.5,and the AUC value of combined detection was equal to 0.796,which was larger than that of each antibody alone.The sensitivity and specificity of combined detection of seven autoantibodies were 49.14% and 82.69%,respectively.The diagnostic efficacy of combined detection of seven autoantibodies was higher than that of single detection.The sensitivity and specificity of CEA+NSE+CYFRA21-1 were 64.65% and 73.07% respectively,and the diagnostic efficiency was better than that of 7-AABs.The sensitivity of 7-AABs+CEA+NSE+CYFRA21-1 detection was significantly increased,which was 81.90%,but the specificity decreased significantly,which was 65.38%,resulting in a higher false positive rate.The levels of seven autoantibodies and the positive rate of combined detection had no significant difference among different pathological types,clinical stages and focus groups(P > 0.05).The positive rate of p53 antibody in small cell lung cancer was significantly higher than that in non-small cell lung cancer,and the positive rate in stage Ⅲ ～ Ⅳ was significantly higher than that in stage Ⅰ ～ Ⅱ.The positive rate of PGP9.5 antibody in lung squamous cell carcinoma was higher than that in lung adenocarcinoma and small cell lung cancer,The differences were statistically significant(P < 0.05).The concentrations of antibodies p53,SOX2,GAGE7,MAGEA1,CAGE in stage Ⅰ ～ Ⅱlung cancer group were significantly higher than those in benign lung disease group.The AUC values of seven autoantibodies in stage Ⅰ ～ Ⅱ lung cancer group were all more than 0.5,and the AUC value of combined detection was equal to 0.770,which was higher than that of each antibody alone.The sensitivity and specificity of the combined detection of the seven autoantibodies were 47.37% and 82.69%,respectively,and the sensitivity and specificity of the seven autoantibodies were 40.35% and 73.07%,respectively,which were significantly lower than those in the lung cancer group.The diagnostic efficiency of 7-AABs in early lung cancer is higher than that of CEA+NSE+CYFRA21-1.There was no significant difference in the concentration of seven autoantibodies and the positive rate of combined detection between patients with non-invasive adenocarcinoma and patients with invasive adenocarcinoma in stage Ⅰ ～ Ⅱ lung adenocarcinoma(P > 0.05).The frequency of spiculation,pure ground glass nodule,vacuole sign and vascular convergence sign in chest thin layer CT sign of stage Ⅰ ～ Ⅱ lung cancer group was higher than that of benign pulmonary disease group,and the frequency of solid nodule in lung benign lesion group was higher than that of stage Ⅰ ～ Ⅱ lung cancer group.There was no significant difference in the frequency of lobular sign,mixed ground glass nodule,bronchial sign and pleural traction sign between the two groups(P > 0.05).Seven autoantibodies combined with chest thin-layer CT examination can increase the diagnostic coincidence rate of patients with early lung cancer from 92.98% to 100%,and the diagnostic coincidence rate of patients with benign pulmonary diseases from 36.54% to 48.08%.Conclusion the combined detection of seven autoantibodies has a certain clinical value in the diagnosis of lung cancer and early lung cancer,and the diagnostic value in the early stage is higher than that of tumor markers.Its expression was not related to different pathological types,clinical stages and lesion size.It can be used to assist chest thin slice CT in early differential diagnosis of benign and malignant tumors of the lung.