Clinical Study And Comparison Of Liquid Detection For Early Diagnosis Of Lung Cancer

BackgrougAt present,lung cancer is still the highest incidence and mortality malignant tumor in the world.In 2018,about 2.1 million new lung cancer cases and 1.8 million deaths were predicted worldwide,ranking first among malignant tumors.Approximately 70%to 75%of the patients were found to have been in the late stage and lost the o opportunity for surgery.Early-stage surgery is the key to reducing the mortality rate in patients with lung cancer.With the development of the guidelines for lung cancer screening in China and the improvement of public health awareness,the population for LDCT is increasing day by day.LDCT can reduce the mortality of lung cancer.However,too high false positive results can lead to unnecessary detection and invasive management(including surgery),LDCT will increase radiation exposure,increase the cost of screening,and its real benefit/risk ratio has not yet been determined.Tumor-related antigens(TAAs)can be produced during the development of the tumor,which can activate the body's immune system to produce a corresponding tumor-associated antigen autoantibody,which is produced prior to the onset of clinical symptoms and stable within the body's blood,So the detection of the tumor autoantibody in the blood provides a new means for the diagnosis of the lung cancer.The liquid biopsy does not cause trauma to the patient,is convenient and quick to operate,can be repeatedly acquired,is easy to be monitored in real time,and the tumor autoantibody in the blood has the potential as a screening marker for early lung cancer.ObjectiveIn our study,we explore the clinical value of autoantibodies against lung cancer in the diagnosis of early lung cancer,we compare the diagnostic efficacy of autoantibodies and CEA in the diagnosis of lung cancer,and we study the combination of seven antibodies and the clinical characteristics of the patients(age,tumor size,smoking)and the association of seven antibodies with CEA in the diagnosis of early lung cancer.The purpose of this study is to provide a new idea for the diagnosis of early lung cancer in the future.MethodsOur study is a diagnostic comparative study of 90 cases of cough from January 2018 to May 2018 in Shandong University affiliated Provincial Hospital.The symptoms such as expectoration or routine examination were examined by LDCT and the blood tumor marker CEA was determined.At the same time,the patients with lung space occupying were resected and pathologically clear after operation.According to the pathological results,they were divided into lung cancer group and benign space occupying group.Seven antibodies:SOX2,GAGE7,P53,PGP9.5,GBU4-5,CAGE and MAGE Al,and tumor marker CEA were selected as detection targets.All patients with pulmonary masses who met the criteria of admission,except those with solid components less than 50%in the ground glass focus,took two tubes of blood(yellow biochemical tube)12 hours after fasting and sent each 5ml to the laboratory immediately,and one tube was used to detect the tumor antibody.Another tube was used to detect CEA(sample size 90 cases).The autoantibodies and CEA values of lung cancer were analyzed bySPSS19.0 statistical software,the relationship between seven autoantibodies and tumor size was analyzed by spearman correlation analysis,and the age of the patients was analyzed by chi-square test.The relationship between smoking and smoking;ROC curve was used to analyze the sensitivity,specificity and AUC value of seven tumor-associated antibodies combined with CEA,autoantibodies to differentiate benign and malignant lesions in the lung only by CEA.There was a significant difference in p<0,05.Results1.The diagnostic results of CEA for lung cancer showed that AUC=0.62(0.51~0.72)had a sensitivity of 0.31 and a specificity of 0.92.The combined diagnostic test of seven antibodies for lung cancer showed that AUC=0.53(0.42 × 0.63)had a sensitivity of 0.59.The sensitivity and specificity of AUC=0.58(0.48 × 0.69)for lung cancer were 0.71 and 0.46,respectively.The specificity of 0.46.CEA combined with seven antibodies was 0.71 and 0.46 respectively.According to the comparison of the diagnostic values of the three indexes and the results of roc curve,the diagnostic value of seven antibodies combined with CEA in lung cancer was significantly higher than that of seven antibodies(p<0.01),and the difference was statistically significant.2.The results of diagnosis of squamous cell carcinoma with seven antibodies showed that AUC=0.54(0.44 × 0.65)had a sensitivity of 0.65 and a specificity of 0.44.The results of the combined diagnostic test of seven antibodies for adenocarcinoma showed that AUC=0.50(0.39 × 0.61)had a sensitivity of 0.58 and a specificity of 0.42.The results showed that there was no significant difference in the diagnostic efficacy between squamous cell carcinoma and adenocarcinoma.3.In this study,Spearman correlation analysis was used to explore the relationship between CEA and seven autoantibodies.The results showed that most of the CEA and seven autoantibodies had no correlation.4.The relationship between seven autoantibodies and the size of the tumor,the age of the group and the history of smoking was discussed by using the Spearman correlation analysis.The results showed that there was no correlation between the seven autoantibodies and the size of the tumor,the age of the group and the smoking.Conclusion1.The sensitivity of the traditional tumor marker CEA to the diagnosis of the lung cancer is 31%,the specificity is 92%,the combined detection sensitivity of seven antibodies(SOX2,GAGE7,P53,PGP9.5,GBU4-5,CAGE,MAGE Al)is 59%,the specificity is 46%,the sensitivity of the seven antibody combination with the CEA is 71%,The specificity is 46%.The combined detection of seven antibodies can make up for the defect that the CEA sensitivity of the tumor marker is not high,and the combination of the two antibodies has higher clinical value for the diagnosis of the lung cancer.2.Seven tumor-related antibodies have no correlation with tumor marker CEA,and both are independent in the diagnosis of lung cancer.Combined detection of these antibodies can improve the diagnostic efficacy of early-stage lung cancer.3.The positive rates of seven tumor-associated antibodies were not correlated with the pathological types of tumors,and had no significant difference in the diagnostic efficacy of squamous cell carcinoma and adenocarcinoma,while the tumor marker CEA was more sensitive to adenocarcinoma.4.There was no correlation between the seven tumor-related antibodies and tumor size,indicating that the diagnostic efficiency of autoantibodies was not affected by tumor size,and it was also highly sensitive to smaller subsolid nodules with solid components.This is also one of the advantages of autoantibodies in the early diagnosis of lung cancer.5.There was no correlation between the seven tumor-related antibodies and the clinical characteristics(age,smoking history)of the patients,indicating that the results of the combined detection of the seven antibodies were not related to the clinical characteristics(age,smoking history)of the patients.This method can avoid the influence of clinical linear data on the detection results to a certain extent,indicating that the combined detection of seven antibodies is superior to the diagnosis of lung cancer.