He Tianyu, Wu Ziheng, Xia Pinghui, Wang Weidong, Sun Hua, Yu Li, Lv Wang, Hu Jian
Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Oncol. 2022 Nov 30;12:1047019. doi: 10.3389/fonc.2022.1047019. eCollection 2022.
Non-small cell lung cancer (NSCLC) is still of concern in differentiating it from benign disease. This study aims to validate the diagnostic efficacy of a novel seven-autoantibody (7-AAB) panel for the diagnosis of NSCLC.
We retrospectively enrolled 2650 patients who underwent both the 7-AAB panel test and CT scanning. We compared the sensitivity, specificity, and PPV of 7-AAB, CT, and PET-CT in the diagnosis of NSCLC in different subgroups. Then, we established a nomogram based on CT image features and the 7-AAB panel to further improve diagnostic efficiency. Moreover, we compared the pathological and molecular results of NSCLC patients in the 7-AABs positive group and the negative group to verify the prognostic value of the 7-AAB panel.
The strategy of a "both-positive rule" combination of 7-AABs and CT had a specificity of 95.4% and a positive predictive value (PPV) of 95.8%, significantly higher than those of CT or PET-CT used alone (P<0.05). The nomogram we established has passed the calibration test (P=0.987>0.05) with an AUC of 0.791. Interestingly, it was found that the 7-AABs positive group was associated with higher proportion of EGFR mutations (P<0.001), lower pathological differentiation degrees (P=0.018), more advanced pathological stages (P=0.040) and higher Ki-67 indexes (P=0.011) in patients with adenocarcinoma.
This study shows that combination of a 7-AAB panel with CT has can significantly enhance the diagnostic efficiency of lung cancer. Moreover, the 7-AAB panel also has potential prognostic value and has reference significance for the formulation of the treatment plan.
非小细胞肺癌（NSCLC）在与良性疾病的鉴别诊断中仍备受关注。本研究旨在验证一种新型七自身抗体（7-AAB）检测组合对NSCLC诊断的有效性。
我们回顾性纳入了2650例同时接受7-AAB检测组合和CT扫描的患者。我们比较了7-AAB、CT和PET-CT在不同亚组NSCLC诊断中的敏感性、特异性和阳性预测值（PPV）。然后，我们基于CT图像特征和7-AAB检测组合建立了列线图，以进一步提高诊断效率。此外，我们比较了7-AAB阳性组和阴性组NSCLC患者的病理和分子结果，以验证7-AAB检测组合的预后价值。
7-AAB与CT的“双阳性规则”联合策略的特异性为95.4%，阳性预测值（PPV）为95.8%，显著高于单独使用CT或PET-CT（P<0.05）。我们建立的列线图通过了校准测试（P=0.987>0.05），曲线下面积（AUC）为0.791。有趣的是，发现腺癌患者中7-AAB阳性组的表皮生长因子受体（EGFR）突变比例更高（P<0.001），病理分化程度更低（P=0.018），病理分期更晚（P=0.040），Ki-67指数更高（P=0.011）。
本研究表明，7-AAB检测组合与CT联合使用可显著提高肺癌的诊断效率。此外，7-AAB检测组合还具有潜在的预后价值，对治疗方案的制定具有参考意义。
