Significance Of Tumor-associated Autoantibodies In The Early Diagnosis Of Lung Cancer

Objectives: To investigate the diagnostic potential of the tumor-associated autoan tibodies(AAbs)panel(p53,NYESO-1,CAGE,GBU4-5,SOX2,Hu D,and MA GE A1 antibody)in screeningstrategy for early stage lung cancer.And the influe nce of clinical factors on the level of autoantibodies was analyzed.Materials and Methods: Patients with cough,hemoptysis,chest pain and other symptoms or physical examination for MDCT,while the pulmonary lesions unde rwent surgical resection and or biopsy in Second Affiliated Hospital of Dalian Medical University between November 2015 and April 2016 were recruited.Lev els of AAbs were measured by ELISA against a panel of seven tumor-associated antigens(p53,PGP9.5,SOX2,GAGE7,GBU4-5,CAGE,and MAGEA1)in lun g cancer group(n=352),benign nodule group(n=45),healthy persons group(n=74).And a panel of tumor markers(CEA?CYFRA21-1?SCC?NSE)were collected in three groups.The AAbs panel is defined positive,when either of AAbs is m ore than its own cutoff.The panel of tumor markers is defined positive,when ei ther of tumor markers is more than its own cutoff.The sensitivity,specificity fo r lung cancer group,benign nodule group,healthy persons group,sensitivity of t he panel in different pathology,stage,size of lesion were compared and analyze d.The sensitivity and specificity of a panel of seven tumor-associated autoantibo dies and a panel of four tumor markers in different stage of NSCLC were com pared and analyzed.Results: 1.The AAbs panel could distinguish malignant lesions from benign lesi onsand healthy people,with sensitivity of 56.53% and specificity of 91.60%.Co mpared to either AAb,the AAbs panel showed significantly higher levels of the positive rate.PPV and NPV for this panel were 95.22% and 45.42%.2.The AAbs panel showed specificity of 91.60 %.When combined with CT,the specificity of the test could be further increased to 95.80%.3.While no significant difference was found in pathology,stages of NSCL C or size of lesion.The sensitivities for stage I to stage IV are 56.39%,57.14%,55.81%,and 56.32%.The sensitivity in extensive SCLC is higher than limi ted SCLC.The primary cause may be due to the small number of SCLC.The sensitivity for tumor size below ?8mm is 56.67%,for 8-20 mm is 55.13%,for20-30 mm is 52.46%,for ?30mm is 57.89%,for more than one lesion is 61.29%4.In stage ?/?of NSCLC,the AUC of AAbs panel in diagnosing lung ca ncer is 0.746 with the sensitivity of 56.57%,the specificity of 91.60 %,and th e AUC of tumor marker panel in diagnosing lung cancer is 0.799 with the sensi tivity of 33.10%,the specificity of 91.60 %;In stage III/IV,the AUC of AAbs panel in diagnosing lung cancer is 0.710 with the sensitivity of 56.15%,the spe cificity of 91.60 %,and the AUC of tumor marker panel in diagnosing lung ca ncer is 0.959 with the sensitivity of 90.80%,the specificity of 91.60%.Conclusion: The AAbs panel can effectively distinguish malignant lesions from benign lesions and healthy people in early diagnosis of lung cancer with higher sensitivity and specificity.While no significant difference in the level of autoanti bodies was found in diffirent pathology,stages of NSCLC or size of lesion.