DOI: https://doi.org/10.21203/rs.3.rs-321719/v1
Objective: Tumor-associated autoantibodies (TAAbs) are produced by the organism in response to peptides at the surface of tumor cells or proteins released by tumors. The purpose of this study is to analyze the expression of TAAbs in different pathological stages and determine their diagnostic value in early non-small cell lung cancer (NSCLC).
Methods: We retrospectively analyzed the expression of 7-TAAbs in 216 newly diagnosed NSCLC patients, 202 patients with lung benign diseases and 137 healthy cases. The expression of a panel of 7-TAAbs, including p53, GAGE7, PGP9.5, CAGE, MAGE A1, SOX2, GBU4-5, was measured by ELISA.
Results: The serum levels of p53, GAGE7, PGP9.5, CAGE, MAGE A1, SOX2 and GBU4-5 were not statistically significant (P>0.05) in NSCLC, benign and healthy groups. The area under the curve (AUC) of 7-TAAbs were all lower than 0.70. The sensitivity of combined detection was the highest (26.39%), while the specificity was the lowest (88.62%). PGP9.5, SOX2, GAGE7, MAGE A1 and combined detection were significantly different among the three groups (P < 0.05). PGP9.5, GAGE7, MAGE A1 and combined detection were significantly different between the NSCLC and benign groups (P < 0.05). PGP9.5, SOX2, GAGE7 and combined detection were significantly different between the NSCLC and healthy groups (P < 0.05). The positive rate of the combined detection of 7-TAAbs was 44.44% in NSCLC stage IV, while that in the other three stages was less than 30.00%.
Conclusions: The sensitivity of 7-TAAbs in early NSCLC was not high, so it cannot be used alone as a screening method for NSCLC. In view of the differences of positive rate between the NSCLC and non- NSCLC groups, 7-TAAbs can be used as a supplementary mean of NSCLC screening.
Table 1. The clinical features of the NSCLC group
group |
NSCLC group %(n) |
|
Pathological classification |
Adenocarcinoma |
83.56(183) |
Squamous carcinoma |
13.89(30) |
|
Adenosquamous carcinoma |
1.39 (3) |
|
Pathological stage |
Stage I |
75.46(163) |
Stage II |
6.48(14) |
|
Stage III |
5.46(12) |
|
Stage IV |
12.50(27) |
|
Typical respiratory symptoms |
Cough |
17.59(38) |
Expectoration |
9.26(20) |
|
Chest pain |
4.17(9) |
|
Chest tightness |
8.33(18) |
|
Regional lymph node status |
N0 |
81.48(176) |
N1 |
3.70(8) |
|
N2 |
4.63(10) |
|
N3 |
10.19(22) |
|
Distant metastasis status |
No distant metastasis |
87.04 (188) |
Distant metastasis |
12.50 (27) |
|
Unable to evaluate |
0.46 (1) |
Table 2. The diagnostic efficiency of 7-TAAbs in NSCLC |
||||||||||||||
|
p53 |
PGP9.5 |
SOX2 |
GAGE7 |
GUB4-5 |
MAGE A1 |
CAGE |
Combined |
||||||
Sen (%) |
2.31 |
3.24 |
3.70 |
7.87 |
10.65 |
4.17 |
2.78 |
26.39 |
||||||
Spe (%) |
98.50 |
100.00 |
99.10 |
98.20 |
92.81 |
99.40 |
98.80 |
88.62 |
||||||
PPV (%) |
50.00 |
100.00 |
72.73 |
73.91 |
48.94 |
81.82 |
60.00 |
60.00 |
||||||
NPV (%) |
60.93 |
61.51 |
61.41 |
62.24 |
61.63 |
61.60 |
61.11 |
65.05 |
||||||
Sen: Sensitivity; Spe: Specificity; PPV: positive predictive value; NPV: negative predictive value. |
Table 3. Comparison of positive rate of 7-TAAbs among the NSCLC, benign and healthy groups |
|||||||||||||
|
Total |
|
|
|
|||||||||
index |
χ2 |
P |
P1 |
P2 |
P3 |
||||||||
P53 |
1.153 |
0.562 |
- |
- |
- |
||||||||
PGP9.5 |
11.126 |
0.004* |
0.015* |
0.046* |
- |
||||||||
SOX2 |
6.323 |
0.042* |
0.223 |
0.025* |
0.275 |
||||||||
GAGE7 |
13.835 |
0.001* |
0.001* |
0.020* |
0.689 |
||||||||
GUB4-5 |
2.435 |
0.296 |
- |
- |
- |
||||||||
MAGE A1 |
9.584 |
0.008* |
0.004* |
0.214 |
0.163 |
||||||||
CAGE |
2.006 |
0.367 |
- |
- |
- |
||||||||
Combined |
24.321 |
<0.001* |
<0.001 |
0.002* |
0.354 |
||||||||
P is the comparison among the NSCLC, benign and healthy groups. P1 is the comparison between the NSCLC and benign groups. P2 is the comparison between the NSCLC and healthy groups. P3 is the comparison between the benign and healthy groups. *P<0.05 was statistically different among the three groups. |