Department of Thoracic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Cancer Sci. 2020 May;111(5):1699-1710. doi: 10.1111/cas.14371. Epub 2020 Mar 19.
The early detection of non-small-cell lung cancer (NSCLC) remains a common concern. The aim of our study was to validate the diagnostic value of a seven-autoantibody (7-AAB) panel compared with radiological diagnosis for NSCLC. We constructed a nomogram and a scoring table based on the 7-AAB panel's result to predict the risk of NSCLC. We prospectively enrolled 268 patients who presented with radiological lesions and underwent both the 7-AAB panel test and pathological diagnosis by surgical resection. A comparison between the 7-AAB panel and radiological diagnosis was performed. A nomogram and a scoring table based on the 7-AAB panel's result to predict the risk of NSCLC were constructed and internally validated. The 7-AAB panel test had a specificity of 90.2% and a positive predictive value (PPV) of 92.7%, which were significantly higher than those of the radiological diagnosis. The 7-AAB panel also showed a preferable sensitivity in patients with early-stage disease. Seven factors, including the 7-AAB panel results, were integrated into the nomogram. For more convenient application, we formulated a scoring table based on the nomogram. The area under the receiver operating characteristic curve was 0.840 and 0.860 in the training group and validation group, respectively, which was higher than that using the 7-AAB panel or radiological diagnosis alone. This study reveals that our 7-AAB panel has clinical value in the diagnosis of NSCLC. The utility of our nomogram and the scoring table indicated that they have the potential to assist clinicians in avoiding unnecessary treatment or needless follow-up.
早期发现非小细胞肺癌（NSCLC）仍然是一个常见的关注点。我们的研究目的是验证七种自身抗体（7-AAB）panel 与影像学诊断 NSCLC 的诊断价值。我们构建了一个列线图和评分表，基于 7-AAB panel 的结果来预测 NSCLC 的风险。我们前瞻性地招募了 268 名有影像学病变且接受 7-AAB panel 检测和手术切除病理诊断的患者。比较了 7-AAB panel 和影像学诊断。构建了基于 7-AAB panel 结果预测 NSCLC 风险的列线图和评分表，并进行了内部验证。7-AAB panel 检测的特异性为 90.2%，阳性预测值（PPV）为 92.7%，明显高于影像学诊断。7-AAB panel 在早期疾病患者中也显示出更好的敏感性。将 7 个因素，包括 7-AAB panel 的结果，整合到列线图中。为了更方便的应用，我们根据列线图制定了一个评分表。训练组和验证组的受试者工作特征曲线下面积分别为 0.840 和 0.860，高于单独使用 7-AAB panel 或影像学诊断的结果。本研究表明，我们的 7-AAB panel 在 NSCLC 的诊断中有临床价值。我们的列线图和评分表的实用性表明，它们有可能帮助临床医生避免不必要的治疗或随访。
