| Background:Lung cancer is one of the most common cancers in the world and one of the leading causes of cancer-related death worldwide[1].The 5-year average survival rate for lung cancer is currently 17.4%,and with 4.2%for advanced lung cancer[2,3].Early diagnosis and early treatment is the key to improving the survival of lung cancer.Early lung cancer is mostly characterized as pulmonary nodules.With the application of low dose spiral computed tomography?LDCT?in lung cancer screening,the detection rate of peripheral pulmonary nodules is 93.8%,lung cancer mortality can be reduced by 20%[4].However,LDCT has a high false positive rate and potential radiotoxicity.In recent years,tumor-associated autoantibodies?T-AABs?have shown good diagnostic value in lung cancer,and have been approved for early diagnosis of lung cancer by some countries in Europe and America[5].Ren et al[6]used 7-AABs and LDCT to screen early lung cancer in high-risk populations in China,and the results showed clinical value.Objective:To evaluate the diagnostic value of a panel of tumour-associated autoantibodies?T-AABs?,including p53,PGP9.5,SOX2,GAGE7,GBU4-5,MAGEA1,and CAGE,which was helpful in the diagnosis of malignant pulmonary nodules.Methods:A retrospective analysis of 208 patients with pulmonary nodules,all patients obtained surgical pathology results.Collecting clinical data?including age,gender,smoking history,etc.?,computed tomography?CT?features,carcinoembryonic antigen?CEA?,neuron specific enolase?NSE?,cytokeratin 19 fragment 21-1?CYFRA 21-1?and AABs results.The receiver operating characteristic?ROC?curve was used to analyze the diagnostic efficacy of the7-AABs panel and single autoantibody alone in malignant tumor nodules.The sensitivity,Specificity and positive predictive value of the 7-AABs panel and traditional tumor markers?CEA,NSE and CYFRA 21-1?were compared in the diagnosis of pulmonary nodules.In addition,we also analyzed the utility of the 7-AABs panel in combination with the Mayo model to improve the diagnostic accuracy of patients with definite lung nodules.The information of CT scaning of pulmonary nodules was observed and recorded,and the CT value and the longest diameter of the nodules were measured.The Chi-square test or t-test was used to compare the positive correlation between the 7-AABs panel and the imaging characteristics of the patient.Results:The sensitivity,specificity and PPV of the 7-AABs panel were 54.7%,87.9%and 92.1%,respectively,and its sensitivity was significantly higher than those of single autoantibody?P<0.001?.The sensitivities of traditional tumor markers?CEA,NSE and CYFRA 21-1?in malignant pulmonary nodules were 6.7%,14.0%,25.3%and 38.0%,respectively.The sensitivity of 7-AABs combined with CEA,NSE and CYFRA 21-1 was increased to 70.0%.The area under the curve?AUC?of the 7-AABs panel and the Mayo model in the diagnosis of malignant pulmonary nodules was 0.699.The positive expression of the 7-AABs panel was correlated with spicule sign and vacuole sign,and was statistically significant?P=0.032,P=0.017?.Conclusions:1.The 7-AABs panel has a high specificity and PPV for the diagnosis of malignant pulmonary nodules,which may be used as a marker for the differential diagnosis of benign and malignant pulmonary nodules.2.The sensitivity of the 7-AABs panel for the diagnosis of malignant pulmonary nodules was significantly higher than that of traditional tumor markers?CEA,NSE and CYFRA 21-1?,and there was no significant difference in specificity.The combined detection of the two groups could improve the diagnostic efficacy.3.The combined detection of the 7-AABs panel and Mayo model can improve the diagnosis accuracy of lung cancer.4.The positive expression of the 7-AABs panel is associated with spicule sign and vacuole sign,which may be helpful in the differential diagnosis of benign and malignant pulmonary nodules. |
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