Potential Value Of Anti-Spindle Antibody Detection For The Diagnosis Of Small Cell Lung Cancer

Background:Early diagnosis of small cell lung cancer(SCLC)is a huge clinical challenge.Anti-spindle antibody(MSA)is an autoantibody associated with the development of SCLC and its diagnostic value in SCLC is unknown.Neuron-specific enolase(NSE)and gastrin-releasing peptide precursor(ProGRP)are clinically long-established tumor markers,yet with insufficient sensitivity or specificity.The value of MSA as a new potential marker alone and in combination with NSE and ProGRP to improve the diagnosis level of SCLC remains to be explored.Objective:The aim of this study was to investigate the value of anti-spin antibody(MSA)alone and in combination with NSE and ProGRP in the diagnosis of SCLC.Methods:A total of 128 patients with SCLC definitely diagnosed in the Second Affiliated Hospital of Nanchang University were enrolled,including 49 patients with limited disease and 79 patients with extensive disease.The control group included 130 patients with non-small cell lung cancer(NSCLC),50 patients with benign lung disease(BLD)Including 12 pulmonary nodules patients,13 chronic obstructive pulmonary disease patients,17 interstitial lung disease patients,8 pulmonary tuberculosis patients and 50 healthy controls(HC).MSA were detected using indirect immunofluorescence(IIF)and ELISA,with NSE and ProGRP detected by electrochemiluminescence.The differences of each indicator levels among groups were compared and analyzed,and the diagnostic value of each index was evaluated by ROC curve.Results:The proportion of smoking individuals in the SCLC and NSCLC groups was 88.29% and 89.23%,and the smoking index was 63.43±26.67 packs/year and 62.17±25.07 packs/year,respectively,which were significantly higher than those in BLD and HC.The positive rate of MSA in the SCLC group was 51.56%,and the levels of MSA,NSE and ProGRP were significantly higher than those in the NSCLC,BLD and HC groups.The AUC(95%CI)of MSA,NSE and ProGRP to diagnose SCLC were 0.856(0.815-0.890),0.809(0.765-0.849)and 0.905(0.870-0.934)respectively.At the optimal cutoff value of 66.36pg/ml,MSA were of the best specificity to diagnose SCLC,up to 93.94%;and when MSA,NSE and ProGRP combined to diagnose SCLC,AUC(95%CI)was 0.964(0.940-0.981).In addition,serum MSA,NSE and ProGRP levels in patients with extensive stage SCLC were significantly higher than the limited stage.Conclusion:MSA serum levels of SCLC patients were elevated,and MSA has moderate performance for SCLC diagnosis,with higher specificity.Combined with NSE and ProGRP,MSA can improve the diagnosis rate of SCLC and can be used as a reference index for SCLC early diagnosis and staging.