Yang Bin, Li Xiaoyan, Ren Tianyi, Yin Yiyu
1China-Japan Union Hospital of Jilin University, Changchun, China.
2National Institutes of Health (NIH)), Bethesda, USA.
Cell Death Discov. 2019 Aug 5;5:126. doi: 10.1038/s41420-019-0207-1. eCollection 2019.
Lung cancer (LC) accounts for the largest number of tumor-related deaths worldwide. As the overall 5-year survival rate of LC is associated with its stages at detection, development of a cost-effective and noninvasive cancer screening method is necessary. We conducted a systematic review to evaluate the diagnostic values of single and panel tumor-associated autoantibodies (TAAbs) in patients with LC. This review included 52 articles with 64 single TAAbs and 19 with 20 panels of TAAbs. Enzyme-linked immunosorbent assays (ELISA) were the most common detection method. The sensitivities of single TAAbs for all stages of LC ranged from 3.1% to 92.9% (mean: 45.2%, median: 37.1%), specificities from 60.6% to 100% (mean: 88.1%, median: 94.9%), and AUCs from 0.416 to 0.990 (mean: 0.764, median: 0.785). The single TAAb with the most significant diagnostic value was the autoantibody against human epididymis secretory protein (HE4) with the maximum sensitivity 91% for NSCLC. The sensitivities of the panel of TAAbs ranged from 30% to 94.8% (mean: 76.7%, median: 82%), specificities from 73% to 100% (mean: 86.8%, median: 89.0%), and AUCs from 0.630 to 0.982 (mean: 0.821, median: 0.820), and the most significant AUC value in a panel (M13 Phage 908, 3148, 1011, 3052, 1000) was 0.982. The single TAAb with the most significant diagnostic calue for early stage LC, was the autoantibody against Wilms tumor protein 1 (WT1) with the maximum sensitivity of 90.3% for NSCLC and its sensitivity and specificity in a panel (T7 Phage 72, 91, 96, 252, 286, 290) were both above 90.0%. Single or TAAbs panels may be useful biomarkers for detecting LC patients at all stages or an early-stage in high-risk populations or health people, but the TAAbs panels showed higher detection performance than single TAAbs. The diagnostic value of the panel of six TAAbs, which is higher than the panel of seven TAAbs, may be used as potential biomarkers for the early detection of LC and can probably be used in combination with low-dose CT in the clinic.
肺癌（LC）是全球肿瘤相关死亡人数最多的癌症。由于LC的总体5年生存率与其检测时的分期相关，因此开发一种经济高效且无创的癌症筛查方法很有必要。我们进行了一项系统综述，以评估单一及组合肿瘤相关自身抗体（TAAbs）在LC患者中的诊断价值。该综述纳入了52篇涉及64种单一TAAbs的文章以及19篇涉及20种TAAbs组合的文章。酶联免疫吸附测定（ELISA）是最常用的检测方法。单一TAAbs对LC各阶段的敏感性范围为3.1%至92.9%（平均值：45.2%，中位数：37.1%），特异性范围为60.6%至100%（平均值：88.1%，中位数：94.9%），曲线下面积（AUC）范围为0.416至0.990（平均值：0.764，中位数：0.785）。诊断价值最显著的单一TAAb是抗人附睾分泌蛋白（HE4）自身抗体，对非小细胞肺癌（NSCLC）的最大敏感性为91%。TAAbs组合的敏感性范围为30%至94.8%（平均值：76.7%，中位数：82%），特异性范围为73%至100%（平均值：86.8%，中位数：89.0%），AUC范围为0.630至0.982（平均值：0.821，中位数：0.820），组合中（M13噬菌体908、3148、1011、3052、1000）最显著的AUC值为0.982。对早期LC诊断价值最显著的单一TAAb是抗威尔姆斯瘤蛋白1（WT1）自身抗体，对NSCLC的最大敏感性为90.3%，其在组合中（T7噬菌体72、91、96、252、286、290）的敏感性和特异性均高于90.0%。单一或TAAbs组合可能是检测各阶段LC患者或高危人群或健康人群中早期LC患者的有用生物标志物，但TAAbs组合的检测性能高于单一TAAbs。六种TAAbs组合的诊断价值高于七种TAAbs组合，可作为早期检测LC的潜在生物标志物，可能在临床上与低剂量CT联合使用。
