The clinical application value of seven tumor-associated autoantibodies in the diagnosis of non-small cell lung cancer / 中华检验医学杂志

ABSTRACT

Objective This study was designed to evaluate the clinical value of seven combinedtumor-associated autoantibodies (7-TAAB) in the diagnosis of non-small cell lung cancer (NSCLC). Methods This is a cross-sectional study. The 81 newly diagnosed patients with NSCLC were enrolled.46 patients with benign pulmonary diseases (BLD) and 55 healthy subjects were selected as the BLD group and the healthy control (HC) group, respectively. ELISA was used to detect the concentration of seven TAABs of p53, PGP9.5, SOX2, GAGE7, GBU4-5, MAGE A1 and CAGE in the serum of the NSCLC and the other two groups. The levels of lung cancer tumor markers CEA, NSE, SCC and CYFRA21-1 in serum were also detected in all enrolled subjects. Kruskal-wallis test was used for comparison among the three groups, Mann-Whitney test was used to evaluate the differences between the two groups, and positivity rates were analyzed by using standard χ2 tests and Fisher exact tests. The receiver operating characteristic (ROC) analyses were performed to evaluate the diagnostic efficacy of 7-TAAB or combination of 7-TAAB and traditional tumor markers. Results The serological levels of six TAABs (p53, SOX2, GAGE7, GBU4-5, MAGE A1, and CAGE) in the NSCLC group were higher than that in the BLD group (p53 Z=-4.370, P=0.000;SOX2Z=-4.412, P=0.000;GAGE7Z=-4.250, P=0.001;GBU4-5Z=-2.678, P=0.025;MAGE A1Z=-4.504, P=0.002;CAGEZ=-4.646, P=0.001) and the HC group (p53Z=-3.543, P=0.000;SOX2Z=-3.383, P=0.002;GAGE7Z=-4.893, P=0.001;GBU4-5Z=-3.381, P=0.025;MAGE A1Z=-3.369, P=0.001;CAGEZ=-2.981, P=0.002),respectively. The differences were statistically significant. The comparison of PGP9.5 in NSCLC group with that in the BLD group was statistically significant (Z=-2.871, P=0.044), with that in the HC group was no difference (Z=-2.280, P=0.05). None of the seven TAABs showed a significant difference between the BLD group and the HC group (p53 Z=-1.917, P=0.917; PGP9.5 Z=-1.228, P=0.966;SOX2Z=-1.789, P=0.325;GAGE7Z=-0.563, P=1.000;GBU4-5Z=-0.315, P=0.985;MAGE A1Z=-2.310, P=0.857;CAGEZ=-2.822, P=0.703). According to the criteria of cut-off value, the detection value of individual TAAB was judged as negative or positive. The specificity of every single TAAB to NSCLC was≥89％, but the sensitivity was≤39.5％. Positive in any of the single TAAB was considered as a positive result of 7-TAAB, the positive rate of 7-TAAB in NSCLC subgroups with early stages (stageⅠand stageⅡ) was considered higher than that of traditional biomarkers (7-TAAB52.94％, CEA23.53％, NSE8.82％, CYFRA21-120.59％, SCC14.71％), and 7-TAAB was more sensitive to NSCLC patients with poor prognosis, such as advanced stages (stageⅢand stageⅣ) and moderately-poorly differentiation. The AUC of 7-TAAB was 0.734, with a sensitivity of 66.67％and a specificity of 80.20％. In coordination with 7-TAAB, CEA, NSE, CYFRA21-1 and SCC, the AUC was 0.917, with a sensitivity of 87.70％ and a specificity of 81.20％.Conclusions 7-TAAB, regarded as a panel of serological markers, is helpful in NSCLC diagnosis and shows broad application prospect. The detection rate of 7-TAAB in patients with early NSCLC is superior to that of traditional serum tumor markers, and the combination of 7-TAAB with CEA, NSE CYFRA21-1 and SCC could improve the diagnosis sensitivity of patients with NSCLC.