7种肿瘤相关抗原自身抗体检测在肺癌诊断中的意义

Clinical significance of seven autoantibodies determination in the diagnosis of lung cancer

目的探讨7种肿瘤相关抗原自身抗体(p53、PGP9.5、SOX2、GAGE7、GBU4-5、MAGE A1和CAGE抗体)在初诊肺癌患者中的临床诊断价值。方法收集我院108例初诊肺癌患者、96例体检健康者、120例肺部良性疾病患者和227例其他癌症患者。ELISA法检测各组血清中7种自身抗体的水平,绘制ROC曲线分析其对肺癌的诊断效能,并比较7种自身抗体联合检测在不同临床病理特征肺癌患者间和各受试组间的阳性率。结果肺癌组7种自身抗体水平均高于健康人对照组、肺部良性疾病组和其他癌症组,差异均有统计学意义(P均<0.05)。7种自身抗体联合检测诊断初诊肺癌患者敏感性为62.00%,特异性为89.80%,AUC^(ROC)为0.769,其敏感性和AUC^(ROC)均高于各自身抗体单项检测。7种自身抗体联合检测在肺癌组的阳性率明显高于健康人对照组(χ~2=50.885,P<0.01)、肺部良性疾病组(χ~2=56.341,P<0.01)以及其他癌症组(χ~2=46.812,P<0.01)。结论 7种肿瘤相关抗原自身抗体联合检测可作为潜在的肺癌辅助诊断指标。

Objective To investigate the diagnostic value of seven tumour-associated autoantibodies, including p53, PGPg. 5, SOX2, GAGE7, GBU4-5, MAGE A1 and CAGE autoantibodies, in the newly diagnosed patients with lung cancer. Methods A total of 108 patients with newly diagnosed lung cancer, 120 with benign lung diseases, 227 with other cancers and 96 healthy controls were enrolled in the study. Their serum levels of seven autoantibodies were detected by enzyme linked immunosorbent assay （ELISA）. The ROC curve was drawn and used to analyze their diagnostic efficiency for lung cancer. The diagnostic value of the combination of seven au- toantibodies in different groups was also compared. Results The serum levels of seven autoantibodies in lung cancer patients were sig- nificantly higher than those in the patients with benign lung diseases or other cancers and healthy controls （ P 〈 0.05 ）. The sensitivity, specificity and AUCR^c of the combination of seven autoantibodies in the preliminary diagnosis of lung cancer were 62.00% , 89.80% and 0.769, respectively, and its sensitivity and AUCR^c were higher than those of single autoantibody. The positive rate of the combi- nation of seven autoantibodies in lung cancer patients was significantly higher than those in healthy controls （Xa = 50. 885, P 〈 0.01 ） and the patients with benign lung diseases （X2 = 56. 341, P 〈 0.01 ） or other cancers （X2 = 46. 812, P 〈 0.01 ）. Conclusion The combination detection of seven autoantibodies, including lO53, PGP9.5, SOX2, GAGE7, GBU4-5, MAGE A1 and CAGE, may serve as potential markers for the diagnosis of lung cancer.