Significance Of Cancer Testis Antigens AKAP4 In The Early Diagnosis Of Non-small Cell Lung Cancer

Objective:Lung cancer is a major global health problem.Early detection and early diagnosis are important for reducing lung cancer mortality and improving survival.Therefore,screening for high-risk patients with lung cancer is particularly important.Cancer testis antigens(CTA)is a kind of tumor associated antigens,which is expressed in a variety of malignant tumors and no or only a little expression in testis and embryonic primitive cells in normal tissues.AKAP4(A-kinase anchor protein 4)is a member of the tumor testis antigen family.This article explores the expression of tumor testis antigen AKAP4 in peripheral blood mononuclear cells for the early diagnosis of non-small cell lung cancer(NSCLC).The significance of the study is also to investigate whether there is a correlation between the expression of tumor testis antigen AKAP4 and clinical data.Methods: Selecting during April 2017 to October 2017 in The Second Hospital of Dalian Medical University because of symptoms such as cough,hemoptysis,chest tightness or due to health examination for Multidetector Row Computed Tomography(MDCT)while biopsy of the lung lesions with pathologic confirmation after surgical resection are recruited.According to the pathological results,all patients are divided into the lung cancer group(n= 91,the pathological type are all non-small cell lung cancer)and the control group(n=104,the pathological types are benign lesions such as tuberculosis and inflammatory lesions).Peripheral blood mononuclear cells(PBMC)from these samples are isolated.RNA is then isolated from PBMC.We determine the cancer testis antigens AKAP4 mRNA expression using Real-time Quantitative PCR Detecting System(qPCR)in these samples.The expression level of AKAP4 mRNA isgreater than its threshold.That is,the patient’s cancer testis antigen AKAP4 is considered positive.Draw the receiver-operating characteristic curve(the ROC curve)and calculate the Area Under Curve(AUC)to evaluate effectiveness evaluation of cancer testis antigens AKAP4 to the diagnosis of non-small cell lung cancer.Use linear regression analysis to investigate cancer testis antigens AKAP4 expression level and the different clinical data(pathological type,TNM staging,gender,age,smoking history)of non-small cell lung cancer patients for correlation.Results:1.ROC curve of AKAP4 expression in the PBMC samples from 91 lung cancer patients and 104 patients with benign lung diseases is 0.886(95% confidence interval0.839 to 0.839),the specificity of 0.933(95% confidence interval 0.730 to 0.896),sensitivity of 0.842(95% confidence interval 0.866 to 0.866).2.ROC curve of AKAP4 expression in the PBMC samples from 44 stage I NSCLC patients and 104 patients with benign lung diseases is 0.883(95% confidence interval 0.811 to 0.955),specificity is 0.933(95% confidence interval 0.865 to 0.972),sensitivity is 0.810(95% confidence interval 0.659 to 0.913).3.The results of linear regression analysis show that there is no correlation between the expression level of AKAP4 and pathological type,TNM staging,sex,age and smoking history(P>0.05).Conclusion:Detection of tumor testis antigen AKAP4 expression in peripheral blood mononuclear cells can be used as a new method for the early diagnosis of non-small cell lung cancer.This method has a high sensitivity and specificity as a simple blood test.The expression of AKAP4 is not associated with the histological type,TNM staging,gender,age,and smoking history of NSCLC.