The Value Of 7 Autoantibodies In The Diagnosis Of Lung Cancer

Objective: To emplore the expression changes and diagnostic value of 7 tumor-associated autoantibodies(7-TAAbs: P53,SOX2,PGP9.5,GAGE7,MAGE A1,CAGE and GBU4-5)in lung cancer patients,with a view to discovering new serological markers for lung cancer diagnosis.Methods: Total of 194 lung cancer patients who were first diagnosed by pathological examination in the Affiliated Hospital of Qingdao University from January 2019 to June 2019 were selected as lung cancer group,and 144 healthy people as healthy group.According to the pathological types,lung cancer group was divided into lung adenocarcinoma(LUAD)group(147 cases),lung squamous cell carcinoma group(LSQCC)group(36 cases),small cell lung cancer(SCLC)group(11 cases);the components of adenocarcinoma group were adenocarcinoma in situ(AIS)group(15 cases),minimally invasive adenocarcinoma(MIA)group(14 cases),invasive adenocarcinoma(IAC)group(118 cases);according to TNM stage,lung cancer group was divided into stage I-II group(148 cases),stage III-IV group(46 cases).Collect the basic clinical data,traditional tumor markers(CEA,NSE,Pro GRP,CYFRA 21-1)serum concentration,chest CT results and other data.The serum expression rates of 7 autoantibodies were detected by enzyme linked immunosorbent assay.The serum expression changes of 7 autoantibodies in lung cancer patients and the relationship between the 7 autoantibodies and pathological types,TNM stage was analyzed by SPSS24.0.The diagnostic value of 7 autoantibodies and combined with tumor markers in lung cancer was analyzed by ROC curve.The value of autoantibodies combined with chest CT in the diagnosis of lung cancer was analyzed by Chi square test.Results:1.The positive rates of 7 autoantibodies in lung cancer group had no statistically significant difference in gender,age and smoking history(all P>0.05).2.Serum concentrations and positive rates of P53,SOX2,PGP9.5,GAGE7,MAGE A1,CAGE and GBU4-5 in lung cancer group were higher than in healthy group(all P<0.05).The seropositive rate of 7 autoantibodies combined detection in lung cancer group was significantly higher than that in healthy group(54.64% vs.19.44%,P<0.05),and the seropositive rates in combined detection was higher than in single detection(54.64% vs.19.07%,18.57%,11.86%,20.10%,13.40%,19.59%,9.28%;all P<0.05).3.Comparison of autoantibodies expression levels among LUAD group,LSQCC group and SCLC group: PGP9.5 seropositivity rate in LSQCC group was higher than that in LUAD group(25.00% vs.8.16%,P<0.05),and there was no significant difference between SCLC group and LUAD group,LSQCC group(all P>0.05).Comparison of autoantibodies serum concentration among AIS group,MIA group,IAC group: GAGE7 serum concentration in IAC group was higher than that in AIS group,MIA group [5.65(3.28-11.03)vs.4.10(2.16-4.90),3.35(1.22-6.82);all P<0.05],but there was no significant difference between AIS group and MIA group(P>0.05).4.The seropositive rate of 7 autoantibodies combined detection was significantly higher in stage I lung cancer group than in healthy group(50.40% vs.19.44%,?2=28.644,P<0.05).But the serum expression of the 7 autoantibodies were not statistically different in stage I-II and stage III-IV of lung cancer(all P>0.05).5.In lung cancer group,NSE was positively correlated with PGP9.5 and CAGE(r=0.297,0.296;all P<0.05).Pro GRP was positively correlated with MAGE A1 and CAGE(r=0.279,0.275;all P<0.05).6.ROC curve analysis showed that the sensitivity of 7 autoantibodies single detections was lower(9.28%-20.62%),and the specificity was higher(93.75%-98.61%).The sensitivity of 7 autoantibodies combined detection increased(56.19%),while the specificity decreased(76.39%).Compared with CEA+NSE+Pro GRP+CYFRA 21-1 combined detection,7-TAAbs combined detection had higher sensitivity and lower AUC(sensitivity: 56.19% vs.48.45%,AUC: 0.686 vs.0.729;all P>0.05).The sensitivity of 7-TAAbs+CEA+NSE+Pro GRP+CYFRA 21-1 combined detection was 67.01%,the specificity was 81.25%,and the AUC was 0.787(95% CI: 0.739-0.829).The sensitivity and AUC of 7-TAAbs+CEA+NSE+Pro GRP+CYFRA 21-1 combined detection are higher than 7-TAAbs or CEA+NSE+Pro GRP+CYFRA 21-1(sensitivity: 67.01% vs.56.19%,48.45%;AUC: 0.787 vs.0.686,0.729;all P<0.05).7.In the diagnosis of lung cancer,the positive rate of 7-TAAbs+chest CT combined diagnosis was higher than chest CT or 7-TAAbs(83.51% vs.70.10%,54.64%,all P<0.05).Conclusion:1.Serum expression levels of 7 autoantibodies in lung cancer are elevated,which suggested that 7 autoantibodies can be used as new markers for the diagnosis of lung cancer.2.Autoantibodies are not affected by the TNM stage,gender,age,smoking history,which can be used for screening of lung cancer,especially early screening.3.The positive rate of PGP9.5 was higher in squamous cell carcinoma than in lung adenocarcinoma,and GAGE7 was more likely to be expressed in lung invasive adenocarcinoma,which can be used to identify different pathological types of lung cancer.4.The diagnostic value of 7 autoantibodies combined detection in lung cancer is significantly higher than single detection;the detection combined with tumor markers can improve the diagnostic value of lung cancer;the detection combined with chest CT can improve the diagnosis rate of lung cancer.