Clinical Significance Of TRAP1,MAD2 And MSA In The Diagnosis Of Small Cell Lung Cancer

Purpose: To explore the clinical significance of tumor necrosis factor receptor-associated protein(TRAP1),mitotic arrest deficient 2(MAD2)and anti-nuclear mitotic spindle apparatus antibody(MSA)in the diagnosis of small cell lung cancer(SCLC).Patients and Methods: Serum concentrations of TRAP1 and MSA were determined by enzyme-linked immunosorbent assay(ELISA),including SCLC group(Num.=86),nonsmall cell lung cancer(NSCLC)group(Num.=105),pulmonary nodules(PN)group(Num.=94),and 60 healthy subjects as control group(Num.=60).Whereas fluorescence quantitative PCR(RQ-PCR)method was used to detect the expression of MAD2.Results:(1)Compared with the healthy control group,the expression level of TRAP1 in SCLC,NSCLC and PN group was decreased,and the expression level was lowest in SCLC(P<0.05);The cut-off value of TRAP1 for SCLC diagnosis was209.26pg/ml,the sensitivity and specificity were 74.42% and 93.33%,and the AUC was 0.899,showing good diagnostic efficacy;TRAP1 level was correlated with the stage of SCLC tumor,and the extensive stage level was significantly lower than the stage limit(P<0.01).(2)The expression of MSA was up-regulated in SCLC and NSCLC groups,with the highest concentration in SCLC group,which was significantly different from that in NSCLC,PN and healthy controls(P<0.01),while The cut-off value of MSA for SCLC diagnosis was 73.87pg/ml,the area under ROC curve was 0.919,and the sensitivity and specificity were83.72% and 81.90%,respectively.(3)Compared with disease control and healthy control groups,MAD2 was overexpressed in SCLC.The AUC of MAD2 for SCLC diagnosis was 0.835,and the sensitivity and specificity were 79.07% and 74.29%,respectively.(4)Combined analysis showed that the diagnostic efficacy of TRAP1 combined with MSA was higher than that of TRAP1 combined with MAD2,with an AUC of 0.988,sensitivity and specificity of 95.35% and 81.90%,respectively.The combined analysis of TRAP1,MAD2 and MSA showed a sensitivity of 97.67% and a specificity of 96.19%.(5)Correlation analysis showed that TRAP1 level was negatively correlated with MSA level(P<0.05),while MAD2 had no significant correlation with the other two.Conclusion: TRAP1 is of great value in the early diagnosis of SCLC as well as differential diagnosis with NSCLC.MAD2 and MSA were up-regulated in the disease group,but the levels were the highest in SCLC.TRAP1 is associated with the clinical stage and lymph node metastasis of SCLC,which is of great significance for early diagnosis and prognosis.The level of TRAP1 can change in PN,which has potential significance for the early prevention of SCLC and even lung cancer.TRAP1 was better than MSA and MAD2 in the diagnosis of SCLC.TRAP1 was negatively correlated with the expression of MSA in serum.TRAP1 combined with MAD2 and MSA can significantly improve the specificity and sensitivity of diagnosis,providing a new clinical diagnosis scheme.