Clinical Value Of Lung Cancer Autoantibodies In The Diagnosis And Differential Diagnosis Of Benign And Malignant Pulmonary Nodules

BackgroundLung cancer is a common malignant tumor with the highest morbidity and mortality.Because there are no obvious special symptoms at an early stage,most lung cancers are found at an advanced stage when they are discovered,thus losing the best opportunity for treatment.Therefore,how to improve the sensitivity and specificity of early diagnosis of lung cancer is an urgent problem.The specificity and sensitivity of traditional lung cancer serum tumor markers for early diagnosis are not ideal,and their value is limited in early diagnosis of lung cancer.Although low-dose computed tomography can improve the sensitivity of early diagnosis,the false-positive rate is high,and it is difficult to distinguish benign and malignant nodules in the lung.This study will systematically evaluate the value of newly developed lung cancer-related autoantibodies and their combined use with low-dose computed tomography in the early diagnosis of lung cancer and the differential diagnosis of benign and malignant nodules in the lung.ObjectiveTo investigate the diagnostic value of seven serum autoantibodies in the differential diagnosis of benign and malignant pulmonary nodules.MethodsFrom October 2018 to February 2019,92 patients with asymptomatic pulmonary nodules were selected and divided into lung malignant nodules group(62 cases)and benign pulmonary nodule group(30 cases)according to pathological results.Healthy people was as the normal control group(25 cases).The expression levels of seven autoantibodies p53,PGP9.5,SOX2,GAGE7,GBU4-5,MAGE A1 and CAGE in the serum of the three groups of subjects were detected by ELISA,and the results were analyzed statistically to evaluate the value of seven autoantibodies alone or in combination in the diagnosis of lung malignant nodules.ResultCompared with the lung benign nodule group and the normal control group,the expression levels of seven lung cancer autoantibodies in the serum of patients with lung malignant nodules were significantly increased,and the difference was statistically significant(P<0.05).There was no statistical difference in the levels of autoantibodies between the benign lung nodule group and the healthy control group(P>0.05);The positive rate of autoantibodies in lung malignant nodules was not related to age,gender,smoking history,nodule size,number of nodules,and nodular properties(P>0.05);The results of ROC curve analysis showed that the AUCs of the seven lung cancer autoantibodies P53,PGP9.5,SOX2,GAGE7,GBU4-5,MAGEA1,and CAGE were0.765,0.710,0.715,0.712,0.754,0.727,and 0.696,respectively,and have certain diagnostic value for malignant pulmonary nodules(P<0.001),and the diagnostic accuracy is higher when combined detection(AUC=0.881);Low-dose computed tomography combined with lung cancer autoantibodies detection can significantly improve the diagnostic accuracy of lung malignant nodule,and its positive predictive value PPV increased from 57.6%(62/92)to 92.7%(51/55)[P<0.001].ConclusionThe combined detection of seven autoantibodies for lung cancer is of high value in the differential diagnosis of benign and malignant nodules of the lung.Low-dose computed tomograph combined with autoantibodies detection can significantly improve the diagnostic accuracy of lung malignant nodules.