The Value Of Seven Autoantibodies In The Diagnosis And Screening Of Lung Cancer

Objective:To explore the value of detection of seven autocorrelation antibodies(p53,GAGE 7,PGP9.5,CAGE,MAGE A1,SOX2,GBU4-5)in the diagnosis and screening of lung cancer.Methods:From June 2018 to January 2020,patients who underwent seven autoantibody tests in Molecular Diagnostic Center of Yunnan Cancer Center were selected.At the same time,the patients were treated for physical examination or lung tumor,accompanied by low-dose computed tomography in the chest.According to the results of chest CT and pathological findings,the patients were divided into three groups:benign group(n=95),lung cancer group(n=99)and healthy group(n=101).Seven autoantibodiesresults were tested by enzyme-linked immunoassay.Any one of the seven autoantibodies is higher than the critical value,it is recorded as the positive test result of the patient's seven autoantibodies.If none of the seven autoantibodies is increased,it is negative.To investigate the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of each antibody and seven antibodiescombined detectionin the diagnosis of lung cancer.And the effects of different clinical characteristics(pathological types and stages)on the detection results of seven autocorrelation antibodies in lung cancer patients were analyzed.Results:1.The positive rates of seven kinds of autoantibodies(p53,PGP9.5,SOX2,GAGE7,gbu4-5,MAGE A1,CAGE)lung cancer group were 9.1%,3.0%,14.1%,14.1%,23.2%,7.1%and 4.0%respectively in the lung cancer group;2.The positive rate of seven autoantibodies combined with detection in the lung cancer group(51.5%)was significantly higher than that in the benign group(5.3%).The difference was statistically significant(?2=50.507;P=0.000);3.In the lung cancer group,the positive rate of seven autoantibodies combined detection(51.5%)was significantly higher than that of the healthy group(6.9%).The difference was statistically significant(?2=48.266;P=0.000);4.The positive rate of seven autoantibodies combined detection in the benign group was 5.3%,and that in the healthy group was 6.9%.The difference between the two groups was not statistically significant(?2=0.237;P?0.626);5.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the combined detection of seven autoantibodies in lung cancer group were 51.5%,94.7%,91.1%,65.2%and 72.7%,respectively;6.The positive rate of seven types of AABs combined detection in adenocarcinoma was 49.3%,while the positive rate of seven types of AABs combined detection in squamous cell carcinoma was 54.2%,and the positive rate of seven types of AABs combined detection in other types of cancer was 62.5%.The difference between the three groups was not statistically significant(?2=0.596;P=0.742);7.The positive rates of the combined detection of seven autoantibodies in different stages of lung cancer were:stage ?:56.0%;stage ?;60.0%;stage ?:66.7%;stage IV:21.1%;8.The positive rates of the combined detection of the seven autoantibodies in stage ?+?+?and ? groups were:58.8%?21.2%,respectively.The difference between the two groups was statistically significant(?2=8.736;P=0.003);Conclusions:1.The sensitivity of the seven autoantibodies alone to the diagnosis of lung cancer is low,which cannot meet the demanding of the diagnosis and screening of clinical lung cancer;2.The combined detection of seven kinds of autoantibodies has certain sensitivity and high specificity for the diagnosis of lung cancer,with the sensitivity of 51.5%,specificity of 94.7%,positive predictive value of 91.1%,negative predictive value of 65.2%,and accuracy of 72.7%.The combined detection can be recommended as a clinical auxiliary diagnostic method;3.Different pathological types had no effect on the positive rate of the combined detection of seven kinds of autoantibodies,so the autoantibodies have good stability for different pathological types in the diagnosis of clinical lung cancer;4.The positive rate of combined detection of AABs in advanced lung cancer is significantly lower than that in stage ?,? and ?,and the positive rate of diagnosis is 21.1%,which may lead to immune escape with the occurrence and development of tumor.Therefore,AABs are not recommended for the diagnosis of advanced lung cancer.