The Value Of Seven Lung Cancer Related Antibodies Combined With Tumor Markers In The Early Diagnosis Of NSCLC

Objective:To explore the value of seven lung cancer related antibodies combined with SCC,CYFRA21-1 and NSE in early diagnosis of NSCLC.Methods:According to the inclusion and exclusion criteria,66 patients with lung cancer were selected as lung cancer group,30 patients with benign pulmonary nodules,33 patients with benign pulmonary disease and 30 healthy subjects as control group.Fasting peripheral blood samples were collected in the morning,and serum seven lung cancer-related antibodies were determined by ELISA,SCC、CYFRA21-1 and NSE were determined by electrochemiluminescence method.The sensitivity of seven lung cancer related antibodies,SCC,CYFRA21-1,NSE and the combination of the two methods were evaluated for the diagnosis of lung cancer and the receiver operating characteristic（ROC）curve was plotted.Results:Among the seven types of lung cancer autoantibodies,the levels of autoantibodies in the lung cancer group were significantly higher than those in the control group,and the differences of P53,PGP9.5,SOX2,GAGE7,MAGEA1 and CAGE autoantibodies were statistically significant（P<0.05）.There was no significant difference in GBU4-5 antibody level between lung cancer group and all control groups（P>0.05）.There were statistically significant differences in the positive rate of autoantibodies in lung cancer group,benign pulmonary nodules group,benign pulmonary disease group and healthy control group（χ2=10.384,P<0.001;χ2=6.699,P<0.05;x2=23.930,P<0.001）.In the detection of traditional tumor markers,there was no significant difference between the tumor markers in lung cancer group and the benign lung nodule group（P>0.05）,and there was no statistically significant difference between the SCC levels in lung cancer group and the benign lung disease group（P>0.05）.Between lung cancer group and lung begin disease group,the differences of the levels of CYFRA21-1 and NSE were statistically significant（P<0.05）,and there were statistically significant differences between lung cancer group and healthy control group（P<0.05）.There was no statistically significant difference in the positive rate of tumor markers in the lung cancer group and the benign pulmonary nodules group（χ2=3.300,P=0.069）,and there was statistically significant difference in the positive rate of tumor markers in the lung cancer group,the benign pulmonary disease group and the healthy control group（x2=9.659,P=0.002;x2=13.748,P<0.001）.Lung cancer group and benign pulmonary nodules,GBU4-5,CAGE area under the curve of the single diagnosis were 0.583,0.658,in the identification of NSCLC and benign pulmonary nodules in the lack of good diagnosis effect,the rest of the five kinds of autoantibodies in the separate identification of NSCLC and benign pulmonary nodules are good diagnosis effect,and when the seven autoantibodies combined NSCLC detection,the diagnostic effect is better than that of autoantibodies alone.The area under the curve of SCC,CYFRA21-1,NSE independent diagnostic efficacy and three combined diagnostic efficacy were 0.466,0.520,0.567,0.570 respectively,the tumor markers had no good diagnostic efficacy in differentiating NSCLC from pulmonary nodules.In lung cancer group and benign lung disease group,the area under the curve of GBU4-5,MAGEA1 and CAGE were 0.534,0.179 and 0.666 respectively,which lacked good diagnostic effect in differentiating NSCLC and benign lung disease.The other four autoantibodies all had good diagnostic effect in differentiating NSCLC and benign lung disease.And when the seven autoantibodies are combined,the diagnostic effect is obviously better than that of each autoantibody alone.The areas under the curves of SCC,CYFRA21-1,NSE independent diagnostic efficacy and three combined diagnostic efficacy were 0.620,0.737,0.790,0.848 respectively.SCC alone did not have good diagnostic efficacy in differentiating NSCLC from benign lung disease.CYFRA21-1 and NSE alone have good diagnostic effect in differentiating NSCLC from benign lung disease,and the three combined methods are significantly more effective than single diagnosis.Tumor markers have good diagnostic effect in differentiating NSCLC from benign lung disease.In the lung cancer group and the healthy control group,the area under the curve of GBU4-5 and CAGE were 0.584 and 0.695 respectively,which lacked good diagnostic effect in differentiating NSCLC from benign lung disease.The other five autoantibodies showed good diagnostic effect in differentiating NSCLC from healthy people.The diagnostic effect is better than that of autoantibodies alone.The areas under the curves of SCC,CYFRA21-1,NSE independent diagnostic efficacy and three combined diagnostic efficacy were 0.736,0.901,0.946 and 0.982 respectively,the three combined and single diagnosis had good diagnostic efficacy,and tumor markers had good diagnostic efficacy in differentiating lung cancer from healthy people.Conclusion:The detection of seven lung cancer related antibodies and tumor markers have reference value for the early diagnosis of NSCLC,and the detection of seven lung cancer related antibodies can improve the detection rate of early NSCLC as a supplementary means of tumor markers detection.