The Value of a Seven-Autoantibody Panel Combined with the Mayo Model in the Differential Diagnosis of Pulmonary Nodules

• Published in: Disease markers 2021, Vol.2021, p.6677823-12
• Main Authors: Ling, Zhougui, Chen, Jifei, Wen, Zhongwei, Wei, Xiaomou, Su, Rui, Tang, Zhenming, Hu, Zhuojun
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Autoantibodies; Autoantibodies - immunology; Benign; Biomarkers; Biomarkers, Tumor - immunology; Biomarkers, Tumor - standards; Chi-square test; Chronic obstructive pulmonary disease; Diagnosis, Differential; Differential diagnosis; Disease; Enzyme-linked immunosorbent assay; Female; Humans; Lung cancer; Lung diseases; Lung Neoplasms - diagnosis; Lung Neoplasms - immunology; Lung nodules; Male; Medical imaging; Middle Aged; Mortality; Nodules; Performance prediction; Prediction models; Predictive Value of Tests; Sensitivity; Solitary Pulmonary Nodule - diagnosis; Solitary Pulmonary Nodule - immunology; Tuberculosis; Tumor markers
• ISSN: 0278-0240; 1875-8630
• DOI: 10.1155/2021/6677823

Background. Identifying malignant pulmonary nodules and detecting early-stage lung cancer (LC) could reduce mortality. This study investigated the clinical value of a seven-autoantibody (7-AAB) panel in combination with the Mayo model for the early detection of LC and distinguishing benign from malignant pulmonary nodules (MPNs). Methods. The concentrations of the elements of a 7-AAB panel were quantitated by enzyme-linked immunosorbent assay (ELISA) in 806 participants. The probability of MPNs was calculated using the Mayo predictive model. The performances of the 7-AAB panel and the Mayo model were analyzed by receiver operating characteristic (ROC) analyses, and the difference between groups was evaluated by chi-square tests (χ2). Results. The combined area under the ROC curve (AUC) for all 7 AABs was higher than that of a single one. The sensitivities of the 7-AAB panel were 67.5% in the stage I-II LC patients and 60.3% in the stage III-IV patients, with a specificity of 89.6% for the healthy controls and 83.1% for benign lung disease patients. The detection rate of the 7-AAB panel in the early-stage LC patients was higher than that of traditional tumor markers. The AUC of the 7-AAB panel in combination with the Mayo model was higher than that of the 7-AAB panel alone or the Mayo model alone in distinguishing MPN from benign nodules. For early-stage MPN, the sensitivity and specificity of the combination were 93.5% and 58.0%, respectively. For advanced-stage MPN, the sensitivity and specificity of the combination were 91.4% and 72.8%, respectively. The combination of the 7-AAB panel with the Mayo model significantly improved the detection rate of MPN, but the positive predictive value (PPV) and the specificity were not improved when compared with either the 7-AAB panel alone or the Mayo model alone. Conclusion. Our study confirmed the clinical value of the 7-AAB panel for the early detection of lung cancer and in combination with the Mayo model could be used to distinguish benign from malignant pulmonary nodules.