The diagnostic value of a seven‐autoantibody panel and a nomogram with a scoring table for predicting the risk of non–small‐cell lung cancer

Abstract

The early detection of non-small-cell lung cancer (NSCLC) remains a common concern. The aim of our study was to validate the diagnostic value of a seven-autoantibody (7-AAB) panel compared with radiological diagnosis for NSCLC. We constructed a nomogram and a scoring table based on the 7-AAB panel's result to predict the risk of NSCLC. We prospectively enrolled 268 patients who presented with radiological lesions and underwent both the 7-AAB panel test and pathological diagnosis by surgical resection. A comparison between the 7-AAB panel and radiological diagnosis was performed. A nomogram and a scoring table based on the 7-AAB panel's result to predict the risk of NSCLC were constructed and internally validated. The 7-AAB panel test had a specificity of 90.2% and a positive predictive value (PPV) of 92.7%, which were significantly higher than those of the radiological diagnosis. The 7-AAB panel also showed a preferable sensitivity in patients with early-stage disease. Seven factors, including the 7-AAB panel results, were integrated into the nomogram. For more convenient application, we formulated a scoring table based on the nomogram.The area under the receiver operating characteristic curve was 0.840 and 0.860 in the training group and validation group, respectively, which was higher than that using the 7-AAB panel or radiological diagnosis alone. This study reveals that our 7-AAB panel has clinical value in the diagnosis of NSCLC. The utility of our nomogram and the scoring table indicated that they have the potential to assist clinicians in avoiding unnecessary treatment or needless follow-up. K E Y W O R D Sautoantibodies, CT scanning, early diagnosis, nomogram, non-small-cell lung cancer R E FE R E N C E S

The role of seven autoantibodies in lung cancer diagnosis

“…This indicates that although autoantibodies can be used for early lung cancer screening, they cannot be used as a means of accurate diagnosis. This result is consistent with Wang et al (8)…”

The combination of a seven-autoantibody panel with computed tomography scanning can enhance the diagnostic efficiency of non-small cell lung cancer

“…In our previous small-scale retrospective study, the 7-AAB panel had a specificity of 90.2% and a PPV of 92.7%, significantly higher than CT scanning. In addition, the utility of the “both-positive rule” combination of 7-AABs and CT has the potential to avoid unnecessary follow-up ( 31 ).…”

Advances in lung cancer screening and early detection

“…Because the autoantibody test's relatively low sensitivity suggests that it is not useful when performed alone for lung cancer diagnosis, it must be combined with another test. When combined with CT or miRNA, the 7-AAB panel has been found to improve the diagnosis of lung cancer and nodules [104][105][106] , but to be accompanied by a high number of false-positive results 107 . This finding might be due to mutations from normal somatic cells inducing immunity and autoantibody production 108 .…”