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通过联合检测 CEA 和 CA125 与自身抗体来提高肺癌的诊断性能。

Enhancement of diagnostic performance in lung cancers by combining CEA and CA125 with autoantibodies detection.

机构信息

Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Oncoimmunology. 2019 Jul 8;8(10):e1625689. doi: 10.1080/2162402X.2019.1625689. eCollection 2019.

Abstract

: Although low-dose computed tomography has been confirmed to have meaningful diagnostic utility, lung cancer is still the leading cause of cancer-related deaths for both genders worldwide. Thus, a novel panel with a stronger diagnostic performance for lung cancer is needed. This study aimed to investigate the efficacy of a new panel in lung cancer diagnosis. : The serum levels of carcinoembryonic antigen (CEA), cancer antigen 125 (CA125) and seven autoantibodies were measured and statistically analyzed in samples from healthy controls and patients with lung cancer. The 316 candidates enrolled in this study were randomly assigned into two groups for the training and validation of a diagnostic panel. : An optimal panel with four biomarkers (CEA, CA125, Annexin A1-Ab, and Alpha enolase-Ab) was established, with an area under the receiver operator characteristic (ROC) curve (AUC) of 0.897, a sensitivity of 86.5%, a specificity of 82.3%, a positive predictive value (PPV) of 88.3%, a negative predictive value (NPV) of 79.7%, and a diagnostic accuracy of 84.8% for the training group. The panel was validated, with an AUC of 0.856 and a sensitivity of 87.5% for the validation group. Furthermore, the new panel performed significantly better in lung cancer screening than did CEA and CA125 in all of the cohorts (< .05). : The diagnostic performance of CEA and CA125 was significantly enhanced through their combination with two autoantibodies (Annexin A1-Ab, and Alpha enolase-Ab). Optimization of the measured autoantibodies is critical for generating a panel to detect lung cancer in patients.

摘要

虽然低剂量计算机断层扫描已被证实具有有意义的诊断效用,但肺癌仍是全球男性和女性癌症相关死亡的主要原因。因此,需要一种具有更强诊断性能的新型肺癌检测面板。本研究旨在探究一种新型面板在肺癌诊断中的效果。

本研究测量了来自健康对照者和肺癌患者样本中的癌胚抗原(CEA)、癌抗原 125(CA125)和七种自身抗体的血清水平,并进行了统计学分析。本研究共纳入 316 例患者,随机分为两组,用于诊断面板的训练和验证。

建立了一个包含四个生物标志物(CEA、CA125、膜联蛋白 A1 抗体和烯醇化酶α抗体)的最佳面板,其受试者工作特征曲线(ROC)下面积(AUC)为 0.897,灵敏度为 86.5%,特异性为 82.3%,阳性预测值(PPV)为 88.3%,阴性预测值(NPV)为 79.7%,训练组的诊断准确率为 84.8%。该面板得到验证,验证组的 AUC 为 0.856,灵敏度为 87.5%。此外,与 CEA 和 CA125 相比,新面板在所有队列的肺癌筛查中表现均显著更好(<0.05)。

CEA 和 CA125 与两种自身抗体(膜联蛋白 A1 抗体和烯醇化酶α抗体)的联合使用显著增强了它们的诊断性能。优化所测量的自身抗体对于生成用于检测肺癌患者的面板至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5e3/6791432/9f8c183600fe/koni-08-10-1625689-g001.jpg

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