Clinical Application Of Tumor-associated Autoantibodies In The Diagnosis Of Lung Cancer

Objectives: The clinical significance of autoantibodies in the diagnosis of lung cancer was evaluated by detecting the level of seven autoantibodies(p53,PGP9.5,SOX2,GAGE7,GAGE7,GBU4-5,CAGE,MAGEA1)in serum of patients with lung cancer.At the same time,the differences in the expression level of serum tumor autoantibodies in patients with different clinical features were analyzed to provide evidence for the clinical diagnosis of lung cancer.Methods: A total of 126 patients were included in this study who were treated in the affiliated hospital of North Sichuan Medical College from July to October of 2017.Levels of seven tumor-associated autoantibodies(AAbs)were measured against a panel of seven tumor-associated antigens in 65 patients who were newly diagnosed of lung cancer and the control group included 29 pulmonary benign disease patients and 31 healthy controls by ELISA.Four traditional tumor markers(CEA?SCC?CYFRA211?NSE)were detected by ECL for three groups.The sensitivity and specificity of single autoantibodies and the combination of seven autoantibodies against lung cancer were analyzed.The effects of different clinical characteristics on the level and positive rate of autoantibodies were analyzed.Comparing the diagnostic value and analyse the correlation between autoantibodies and traditional tumor markers.Result: 1.The levels of seven autoantibodies in lung cancer group were higher than those of pulmonary benign disease group and healthy control group,the difference was statistically significant(p<0.05);the positive rate of single autoantibodies and its combinations in lung cancer group were higher than control group,the difference was statistically significant(p<0.05).2.The sensitivity of single autoantibody detection to lung cancer diagnosis was range in 12.3-21.5%,specificity was range in 93.4-100%,The sensitivity of the combined detection of seven autoantibodies were 71.4%,and the specificity were 84.3%,respectively.3.The positive rate of the combined decetion of seven autoantibodies in lung cancer group were not affected by gender,age,smoking,pathological type,TNM stage,lymph node metastasis and tumor size.4.The level of p53 autoantibodies in squamous carcinoma was higher than adenocarcinoma with statistical significance(p<0.05);the level of GAGE7 autoantibodies of patients in stage and was higher than whom ? ?in stage ?and ?,at the same time,the level of GAGE7 is higher in the patients with lymph node metastasis than not,the difference was statistically significant(p<0.05);the level of p53 autoantibodies in patients smoked was higer than never,the difference was statistically significant(p<0.05).5.The level of p53 autoantibodies were negatively correlated with CEA,and MAGEA1 autoantibodies were positively correlated with SCC.6.The AUC of combined detection of seven autoantibodies in stage?/?and stage ?/ was ?0.859/0.886,the AUC value of combined detection of four traditional makers in stage?/?and stage ?/ was 0.841/0.937.? Conclusion: 1.Detection of single autoantibody have high specificity and low sensitivity in the diagnosis of lung cancer,cannot meet the needs of clinical diagnosis lung cancer.2.The combined detection of seven autoantibodies have high specificity and sensitivity,the positive rate were not effected by histopathologic types,TNM stage,tumor size and lymph node metastasis,it can be used as an new method for the diagnosis of lung cancer.3.GAGE7 autoantibody can be used as an indicator to evaluate the tumor load and therapeutic effect of lung cancer,further experimental verification is needed?4.p53 autoantibodies may be used as a marker for the identification of squamous carcinoma and adenocarcinoma in the patients with lung cancer.