Abstract:

Objective To explore the application value of serum melanoma-associated antigen A3 （MAGEA3） and human epididymis protein 4 （HE4） in the auxiliary diagnosis of lung cancer patients. Methods A total of 134 patients with lung cancer who underwent treatment at Qingdao Central Hospital， University of Health and Rehabilitation Sciences from January 2021 to January 2024 were selected as study subjects （study group）， and 158 healthy people who underwent physical examination during the same period were selected as control group. Enzyme linked immunosorbent assay was applied to measure the serum level of MAGEA3 and HE4. According to the median MAGEA3 and HE4 levels before treatment of the study group， lung cancer patients were divided into MAGEA3 high level group （≥58.69 pg/ml， n=66）， low level group （<58.69 pg/ml， n=68） and HE4 high level group （≥125.04 pmol/L， n=69） and low level group （<125.04 pmol/L， n=65）. Receiver operator characteristic （ROC） curves were plotted to evaluate the diagnostic performance of serum MAGEA3 and HE4 level for lung cancer before treatment. Results Serum MAGEA3 and HE4 levels before treatment in the study group were （58.69±16.14） pg/ml and （125.04±28.49） pmol/L， and those in the control group were （43.52±14.83） pg/ml and （96.85±22.33） pmol/L， respectively. The levels of MAGEA3 and HE4 in the study group were significantly higher than those in the control group， with statistically significant differences （t=8.36， P<0.001； t=9.47， P<0.001）. Serum MAGEA3 and HE4 levels after treatment in the study group were （46.73±15.42） pg/ml and （113.26±24.73） pmol/L， respectively， serum MAGEA3 and HE4 levels after treatment were significantly lower than those before treatment， with statistically significant differences （t=16.07， P<0.001； t=9.27， P<0.001）. There were significant differences in differentiation degree （χ²=6.20， P=0.013）， TNM staging （χ²=7.27， P=0.007） and lymph node metastasis （χ²=7.07， P=0.008） of lung cancer patients between the MAGEA3 high level group and the low level group before treatment. There were significant differences in differentiation degree （χ²=4.93， P=0.026）， TNM staging （χ²=7.31， P=0.007） and lymph node metastasis （χ²=9.85， P=0.002） of lung cancer patients between the HE4 high level group and the low level group before treatment. The ROC curve analysis showed that， the area under the curve （AUC） of serum MAGEA3 and HE4 alone for diagnosing lung cancer before treatment were 0.77 （95%CI： 0.72-0.83） and 0.76 （95%CI： 0.70-0.81）， and the AUC of the above two combined for diagnosing lung cancer was 0.87 （95%CI： 0.83-0.91）， and the combined diagnosis value of the two was higher than that of MAGEA3 （Z=2.92， P=0.003） and HE4 （Z=3.24， P=0.001） alone. Conclusion Compared with healthy people， serum MAGEA3 and HE4 levels before treatment of lung cancer patients are significantly increased， and serum MAGEA3 and HE4 levels are significantly lower after treatment than those before treatment. The combination of the two is more effective in diagnosis for lung cancer and can be used as an auxiliary diagnostic tool for lung cancer patients.

Key words: Lung neoplasms, Diagnosis, Melanoma-associated antigen A3, Human epididymis protein 4