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The real-world research of lung cancer-associated autoantibodies and serum tumor markers

Feng Chen  Xiaoqian Xu  Fan Ren  Jun Chen  Song Xu  
【摘要】:Background: Lung cancer is one of the most common malignant tumors in the world, and it is also the main cause of death for both sexes. Early detection and treatment are considered to be the main means to reduce mortality. At present, the strategy of lung cancer screening is conducting low-dose computed tomography(LDCT), however there is risk of false positivity and radiation exposure. In order to avoid these problems, some hematological biomarkers are used in the auxiliary diagnosis and screening of lung cancer. Currently, serum tumor markers and seven autoantibodies are widely used clinically.Materials and Methods: Enzyme-linked immunosorbent assay(ELISA) is used to detect the expression levels and positive expression rate of seven autoantibodies(AABs) and tumor markers in serum of 354 patients with lung cancer and 108 patients with benign pulmonary diseases in the real world.Results: Through the analysis of real-world data, the sensitivity, specificity, PPV and area under ROC curve of seven AABs were 30.0%, 84.3%,86.3% and 0.61 respectively; the sensitivity of seven AABs combined with tumor markers was 68.6%, the specificity was 52.8%, and the area under the ROC curve was 0.72. The positive expression rate of seven AABs in patients with lung cancer was significantly higher than those with benign expression diseases(30.1% vs. 15.7%). Combined seven AABs with tumor markers, the positive rates increased to 68.6%. The positive expression of seven AABs was affected by clinical features and pathological stages, among which the expression rate of stage I was the lowest, only 17.1%.Conclusion: Through the analysis of real-world data, the value of seven AABs as auxiliary diagnosis of lung cancer has been affirmed. However, due to its low sensitivity and susceptibility to clinical features, its application in lung cancer screening is limited. After the combination of tumor markers,although the sensitivity increased, but the specificity decreased, the false positive rate increased, and it was easily affected by clinical features, so the combination of seven AABs and tumor markers in lung cancer screening still needs further research.

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