血清中7种肺癌自身抗体对非小细胞肺癌的诊断及预后不良的应用价值  

Application value of seven lung cancer autoantibodies in the diagnosis and poor prognosis of non-small cell lung cancer

作　　者：邓燕[1] 赵界[1] 罗文[1] 邱容[1] DENG Yan;ZHAO Jie;LUO Wen;QIU Rong(Department of Respiratory Medicine,Suining Central Hospital of Sichuan Province,Suining,Sichuan 629000,China)

机构地区：[1]四川省遂宁市中心医院呼吸科,四川遂宁629000

出　　处：《检验医学与临床》2024年第22期3279-3285,共7页Laboratory Medicine and Clinic

基　　金：四川省中医药管理局科学技术研究专项课题(2021MS164)。

摘　　要：目的探讨血清中7种肺癌自身抗体检测在非小细胞肺癌(NSCLC)临床诊断及预后不良中的应用价值。方法采用回顾性病例对照研究方法收集2017年1月至2018年10月该院收治的173例肺结节患者的临床资料,将其中经临床检查及病理学检查确诊的80例NSCLC患者作为恶性组,将确诊的93例良性肺结节患者作为良性组,另回顾性选取同期在该院进行健康体检的69例健康者作为对照组。所有研究对象均于确诊前或体检时检测血清中7种肺癌自身抗体[肿瘤蛋白P53(P53)、神经元胞质蛋白基因产物9.5(PGP9.5)、干细胞转录因子(SOX2)、G抗原7(GAGE7)、肿瘤抗原4-5(GBU4-5)、黑色素瘤抗原A1(MAGEA1)、肿瘤相关基因(CAGE)]。比较恶性组、良性组和对照组血清P53、PGP9.5、SOX2、GAGE7、GBU4-5、MAGEA1、CAGE水平及其阳性检出率,并绘制基于血清中7种肺癌自身抗体诊断NSCLC及评估预后不良的受试者工作特征(ROC)曲线,观察灵敏度、特异度及曲线下面积(AUC)。另随访1年,根据预后情况将恶性组又分为预后良好组和预后不良组。分析血清中7种肺癌自身抗体水平与NSCLC患者预后的关系。结果恶性组血清P53、PGP9.5、SOX2、GAGE7、GBU4-5、MAGEA1、CAGE水平及其阳性检出率均高于良性组和对照组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,血清P53、PGP9.5、SOX2、GAGE7、GBU4-5、MAGEA1、CAGE单独及联合检测诊断NSCLC的灵敏度分别为30.00%、23.75%、28.75%、33.75%、25.00%、42.50%、26.25%、68.75%,特异度分别为98.15%、96.91%、93.83%、98.15%、98.15%、87.04%、97.53%、79.01%,AUC分别为0.563、0.498、0.456、0.429、0.407、0.392、0.374、0.705。预后不良组血清P53、PGP9.5、SOX2、GAGE7、GBU4-5、MAGEA1、CAGE水平及其阳性检出率均高于预后良好组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,血清P53、PGP9.5、SOX2、GAGE7、GBU4-5、MAGEA1、CAGE单独及联合检测预测NSCLC患者Objective To investigate the application value of seven lung cancer autoantibodies in the clinical diagnosis and poor prognosis of non-small cell lung cancer(NSCLC).Methods A retrospective case-control study was conducted to collect the clinical data of 173 patients with pulmonary nodules admitted to the hospital from January 2017 to October 2018.Among them,80 patients with NSCLC confirmed by clinical examination and pathological examination were selected as the malignant group,and 93 patients with benign pulmonary nodules were selected as the benign group.In addition,69 healthy people who underwent physical examination in the same hospital during the same period were retrospectively selected as the control group.Seven lung cancer autoantibodies[tumor protein P53(P53),neuronal cytoplasmic protein gene product 9.5(PGP9.5),stem cell transcription factor SOX2(SOX2),G antigen 7(GAGE7),tumor antigen 4-5(GBU4-5),and melanoma antigen A1(MAGEA1)]were detected in serum of the all subjects before diagnosis or during physical examination.The levels of serum P53,PGP9.5,SOX2,GAGE7,GBU4-5,MAGEA1 and CAGE in malignant group,benign group and control group and their positive detection rates were compared,and the receiver operating characteristic(ROC)curves for the diagnosis of NSCLC and the evaluation of poor prognosis based on the seven lung cancer autoantibodies in serum were drawn,and the sensitivity,specificity and area under the curve(AUC)were observed.The patients were followed up for 1 year,according to the prognosis,the patients in malignant group were divided into good prognosis group and poor prognosis group.The relationship between the levels of seven lung cancer autoantibodies and the prognosis of NSCLC patients was analyzed.Results The levels and positive rates of serum P53,PGP9.5,SOX2,GAGE7,GBU4-5,MAGEA1 and CAGE in the malignant group were higher than those in the benign group and the control group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the sensitivity of serum P53

关 键 词：非小细胞肺癌 自身抗体 诊断价值 预测价值 预后不良 

分 类 号：R734.2[医药卫生—肿瘤] R446.1[医药卫生—临床医学]