Detection Of Autoantibodies To Multiple Tumor-associated Antigens In Diagnosis Of Lung Cancer

Background and ObjectiveLung cancer is one of the most common malignancies,both the incidence rate and mortality rate of lung cancer have been on the rise,with its mortality rate ranking the first among various kinds of malignancies.The majority of lung cancers remain clinically undetectable until patients have developed to the advanced-stage disease, and the five-year survival rate of lung cancer only accounts for less than 15%.The main reason for such a high mortality rate is that lung cancer is difficult to be diagnosed at the early stage.Therefore,it is crucial to search a useful method which can diagnose lung cancer at the early stage.TAA(tumor-associated antigen) is one of the major research topics in modern oncology,while the TAA detection of lung cancer has become an important target for the diagnosis of the malignancy.But TAA shows its limitations in the diagnosis of lung cancer,and would not satisfactory in the sensitivity and specificity.Therefore,we have used a multiple TAAs including Koc, p62,CyclinE,CyclinB1,Imp1,p16,Suil,Survivin,Calnuc,C-myc,p53,CyclinD1, CDK2,cIAP1 or RalA in detection anti-TAA antibodies for the diagnosis of lung cancer.The aim of this study is to evaluate the diagnostic value of a TAA array in detection of anti-TAA antibodies for the diagnosis of lung cancer. Materials and Methods1.Sample preparation:in this study,all patients were divided into two groups: lung cancer group consisted by 174 cases,109 males and 65 females,age from 35 to 84 years,mean age 62.6±11.7 years,all cases had been proved by pathologic diagnosis;health comparison group consisted by 92 cases,38 males and 54 females, age from 19 to 76years,mean age 50.6±15.1 years.2.The enzyme-linked immunoassay assay(ELISA) was performed to detect all TAAs antibodies,and the slot blot was used to checking the results of the ELISA.3.Statistical analysis:all date were analyzed by SPSS 13.0.In the statistics analysis,χ~2 test and the exact probability of fourfold table were used;size of the testα=0.05.Results1.The positive gender rate of the fifteen TAA,which was detected in this study, in lung cancer and health comparison group:p16 is 25.9%,2.2%,respectively;RalA is 14.4%,3.3%,respectively;Koc is 9.8%,2.2%,respectively;CyclinD1 is 12.1%, 2.2%,respectively;p62 is 17.2%,3.3%,respectively;Suil is 16.1%,4.3%, respectively;cIAP1 is 12.6%,0%,respectively;CyclinE is 21.3%,3.3%,respectively; Calnuc is 27.0%,2.2%,respectively;Imp1 is 21.3%,1.1%,respectively;Survivin is 14.9%,1.1%,respectively;p53 is 24.1%,3.3%,respectively;C-myc is 22.4%,0%, respectively;CyclinB1 is 16.1%,3.3%,respectively;CDK2 is 11.5%,3.3%, respectively.2.In serum samples from patients with lung cancer,the positive gender rate of Koc,Suil,Survivin,p62,CyclinE,Imp1,p16,Calnuc,C-myc,p53,CyclinD1, CyclinB1,CDK2,cIAP1 and RalA is remarkably higher than that in the health comparison group,the difference has statistical significance(P＜0.05).3.The positive gender rate of p62 and p16 in the lung cancer group have relation with the pathology type of lung cancer.The highest pathology type in p62 and p16 is squamous cell carcinoma,respectively is 48.3%,27.6%.Compared with other pathological types,the difference has statistica significance(P＜0.05).4.The sensitivity,specificity,Youden's index,positive predictive value,negative predictive value,positive likelihood ratio,agreement rate value and Kappa of the 15 anti-TAA antibodies in detection of lung cancer is 73.0%,90.2%,0.632,93.4%, 63.8%,7.45,78.9%,0.58,respectively.Conclusions1.The expression of Koc,Suil,Survivin,p62,CyclinE,Imp1,p16,Calnuc, C-myc,p53,CyclinD1,CyclinB1,CDK2,cIAP1 and the RalA in lung cancer group is higher than the health group.This is useful to diagnose lung cancer.2.p16 and p62 have certain value to the lung cancer diagnosis,and the positive gender rate in the squamous cell carcinoma is higher than that in the adenocarcinoma. This result indicates that the detection of p16 and p62 is useful to judge the pathology type of lung cancer.3.There is no statistical significance in all TAAs which were detected in this study between different sex groups;except RalA and Calnuc,all other TAAs all do not have statistical significance between different age groups.4.The combinational application of 15 TAAs could be a valuable method.This approach can raise the sensitivity rate in serological diagnosis of lung cancer.