Study On The Diagnostic Value Of Seven Autoantibodies Of Lung Cancer Combined Monitoring With Chest CT Computer-Aided Diagnosis In Lung Cancer

BACKGROUND:Lung cancer is one of the malignant tumors with the highest incidence rate and mortality in the world,and it has gradually increased in recent years.Because early lung cancer often has no symptoms,most patients with lung cancer have developed to the middle and late stage when diagnosed,and their five-year survival rate is very low.Compared with patients with advanced lung cancer,the five-year survival rate of early lung cancer is significantly higher..At present,there is an urgent need for a reliable detection method to screen early lung cancer.Objective:To evaluate the diagnostic value of seven lung cancer-related autoantibodies（p53,PGP9.5,SOX2,GAGE7,GBU4-5,MAGEA1 and CAGE）and computer-aided diagnosis combined with chest CT in early lung cancer screening.Methods:The serum samples and chest CT of 153patients with lung cancer（lung cancer group）,51 patients with benign lung tumor（lung benign tumor group）,and 53 healthy people（healthy control group）were collected from January 2021 to December 2021 at Shengjing Hospital affiliated to China Medical University.The levels of seven autoantibodies in different test groups were detected by enzyme-linked immunosorbent assay（ELISA）,and the differences of the levels and positive rates of the seven autoantibodies in different groups of people and different pathological types of lung cancer were compared.The receiver operating characteristic（ROC）curve was drawn,and its diagnostic efficiency for lung cancer was analyzed,and the chest CT of each group was used for computer-aided diagnosis,To evaluate the value of autoantibody combined with chest CT in the diagnosis of lung cancer.Results:1.The expression levels of seven lung cancer-related autoantibodies（p53,PGP9.5,SOX2,GAGE7,GBU4-5,MAGE A1 and CAGE）in the serum of lung cancer patients were higher than those of the benign lung cancer group and the healthy population group,and the difference between GAGE7（p<0.05）and MAGE（p<0.05）was statistically significant.2.There was no statistically significant difference in the serum expression level of seven lung cancer related autoantibodies among people with different age,sex,and smoking history（p>0.05）.3.Among the seven lung cancer related autoantibodies,the antibody level of MAGE A1 in patients with squamous cell carcinoma was significantly higher than that in patients with adenocarcinoma,and the antibody level of MAGE A1 in patients with intermediate and advanced lung cancer was significantly higher than that in early stage patients（p<0.05）,and there was no significant difference between the other lung cancer autoantibody groups.4.The positive rate of seven autoantibodies in all subjects was 22.18%.The positive rate of seven autoantibodies in lung cancer group was 30.07%.The positive rate of combined detection of 7 autoantibodies in lung cancer group was significantly higher than that in benign lung cancer group and healthy control group（χ2=14.569,p<0.05）.The sensitivity,specificity,and AUC^ROCof the combined detection of seven autoantibodies were 30.07%,90.53%,and 0.604.The sensitivity and AUC^ROCof 7-TAABs were higher than those of single antibody detection,but the area under the ROC curve of 7-TAABs was not statistically significant compared to p53 and MAGEA1.Five Seven types of lung cancer related autoantibodies have high specificity in the diagnosis of lung cancer,but their sensitivity is relatively low.Although combined detection can improve sensitivity,the degree of improvement is limited（30.07%）,sensitivity,positive predictive value,and negative predictive value were significantly improved（97.22%,83.33%,94.12%）.Compared with the use of 7-TAABs and CAD alone,The area under the ROC curve of SOX2+CAD and 7-TAABs+CAD significantly increased（p<0.05）,and the difference between them was not statistically significant（p>0.05）,which has good diagnostic value.Conclusion:1.The individual diagnostic value of seven lung cancer related autoantibodies is limited,and joint detection can improve the accuracy of lung cancer diagnosis to a certain extent,which has certain reference value for clinical diagnosis of lung cancer;2.The lung cancer related autoantibody MAGE A1 has certain value in determining the pathological classification,staging,and prognosis of lung cancer;The combined detection of lung cancer autoantibodies and chest CT computer-aided diagnosis has high diagnostic value and can play a certain role in lung cancer screening.