Determination And Evaluation Of Serum Monosaccharides In Patients With Visceral Pleural Invasion Of Lung Adenocarcinoma In Early Stage

Objective:To compare the levels of degraded monosaccharides in the serum of patients with earlystage lung adenocarcinoma and healthy controls,and to explore and analyze the auxiliary diagnosis and evaluation value of biomarkers based on glycomics in early-stage lung adenocarcinoma.Method:In the study,268 serum samples from lung adenocarcinoma(LUAD)confirmed by postoperative pathological examination and with T stage less than T2 a were included,including 53 patients with visceral pleural invasion(VPI)pathological behavior.According to the age-sex matching method,268 healthy people who underwent physical examination in the hospital during the same period were matched as the control group.In the early-stage lung adenocarcinoma patient group(LUAD group),53 lung adenocarcinoma patients without VPI pathological behavior(non-visceral pleural invasion,NVPI)were matched in the LUAD group as controls.Serum samples were degraded by hydrochloric acid,and the degraded eight monosaccharide components were quantitatively analyzed by the established high performance liquid chromatography.The Mann-Whitney U nonparametric test was used to compare the concentration differences of degraded monosaccharides in serum samples between the two groups;receiver operating characteristic(ROC)and area under the curve(AUC)were used to evaluate the pathological behavior of different types of monosaccharides on VPI The diagnostic efficacy of all sugar fingerprint models was evaluated by combining different monosaccharides to construct models through multivariate logistic regression.Result:1.In the LUAD group and the healthy control group,the differences of the eight degraded monosaccharides were statistically significant,among which,in the LUAD group,mannose(Man),glucosamine(Glc N),galactosamine(Gal N),glucose The contents of uronic acid(Glc UA),glucose(Glc),galactose(Gal)and fucose(Fuc)were higher than those in the control group,while merely xylose(Xyl)was lower than those in the control group,and the differences were statistically significant.2.The levels of mannose,glucosamine,and galactose in the VPI group were significantly higher than those in the NVPI group(p<0.05),while the levels of glucuronic acid and xylose were lower than those in the NVPI group.Statistical significance(p<0.05).3.Multivariate Logistic regression included Man,Glc N,Glc UA,Gal,Xyl and Fuc to construct the model,and the AUCs were 0.7203,0.7361,0.8850,0.5844,0.8486 and 0.7403respectively;the jointly constructed diagnostic model Model-L can be very good The AUCs were 0.9482,and the model sensitivity and specificity were 83.2% and 92.5%.In the retrospective validation group,the Model-L showed stable performance with sensitivity of87.8%,specificity of 84.2,and accuracy of 86.6%.4.Among the eight degraded monosaccharides,the AUCs of Man,Glc N,Glc UA,Gal,Xyl and Fuc with statistically significant differences were 0.8494,0.6177,0.6230,0.6639,0.6335 and 0.7120,respectively.The monosaccharide Man,Glc N,Glc UA and Fuc were included in the multivariate Logistic regression model Model-V construction,which has a high diagnostic value for the detection of VPI pathological state,the AUC was 0.9227,and the sensitivity and specificity were 84.9% and 90.6%,respectively.In the retrospective validation group,the validation results showed that sensitivity of 68.4%,specificity of80.8%,and accuracy of 77.5%.Conclusion:1.Among the eight kinds of monosaccharides detected,the distribution of six kinds of mannose,glucosamine,glucuronic acid,galactose,xylose and fucose was different between VPI group and NVPI group in patients with early stage lung adenocarcinoma.Groups of patients had different "glycan fingerprint" characteristics.2.The diagnostic model constructed according to the serum monosaccharide content showed good diagnostic performance in distinguishing whether the early lung adenocarcinoma patients had visceral pleural invasion pathological features,and had certain reference significance for clinical diagnosis and evaluation.3.The changes of monosaccharide components are also different in patients with different pathological characteristics,which is a promising biomarker.