The Clinical Value Of Serum Glycoprotein In The Early Surgical Intervention Of Lung Nodules

Lung cancer is one of the most common malignant tumors with the highest morbidity and mortality,which seriously threatens human health.Ground-glass nodule(GGN)is a common imaging manifestation of pulmonary nodules.In the past five years,with the development and popularization of low dose spiral CT as a screening technique for chest examination,the detection rate of GGN was dramaticlly increased.Clinically,surgical resection is the main treatment for GGN patients.However,the question of when to have surgery is still a controversial issue.At present,the clinical practice to perform a surgery is generally combined with GGN site,size,quantity,whether there is no substance,the changes in the follow-up process and the patient's psychological ability.The clear surgical indications for GGN patients,especially for those less than 10 mm has strong subjectivity and arbitrariness.Therefore,find a noninvasive serological indicator which can reflect the pathological differences in GGN patients,to screen the high-risk patients for early surgical intervention and keep the low-risk patients for follow-up,has important significance for improving the life quality of GGN patients.Glycosylation is an important post-translational modification of proteins,which is widely involved in the various processes of cell activities.The change of protein glycosylation is closely related to the immune status,and immune evaluation and immunotherapy have become a new window and a new hot spot for early diagnosis and surveillance of tumor.In this study,we investigated the glycan changes on the immune related glycoprotein IgG using the new technology lectin microarray,to explore the connection between the glycan changes and the development of GGN.The main results are as following:1.We performed statistical analysis in 1316 patients with pulmonary nodules regarding to the gender,age,the number of nodules,nodule size,nodule location,distribution of benign and malignant nodules.We found that the middle-aged women with 40-69 years is the main population of pulmonary nodules(especially in GGN patients),and the upper lobe of the right lung is more prone to have pulmonary nodules.Moreover,the size of the pulmonary nodules in the majority of GGN patients were less than 1.0cm,while the size in patients with nodules were evenly distributed from 0.6cm to 2.5cm.However,the routine blood routine indexes and the conventional tumor markers can not distinguish the benign and malignant nodules.2.We establised a analysis platform for glycan changes based on the technology lectin microarray,and applied for investigation of serum IgG purified from non invasive GGN patients and invasive GGN patients for the first time.In these 103 GGN patients,we found the levels of sialylation,high mannose glycosylation and poly-GlcNAc glycosylation were signicantly decreased in invasive GGN patients.In addtion,we constructed a combined diagnosis model using four lectin probes and the CT values,which could greatly improve the diagnostic accuracy of invasive GGN patients.3.We also investigated the glycome profiles of Fab fragments from serum Ig G protein in 58 GGN patients.We found that the levels of high mannose glycosylation were signicantly decreased in invasive GGN patients.The diagnosis model combined two lectin probes(NPA and Calsepa)and the CT values improved the diagnostic accuracy of invasive GGN patients.In summary,this study performed a comprehensive analysis of glycan profiling for serum IgG from GGN patients using lectin microarray.The selected lectin probes can be the potential biomarker candidates for early diagnosis of GGN.This study provide new insights of clinical diagnosis,choice of treatment nd prognosis of early warning for GGN patients.