Application of radiological indicators combined with the methylation of HOXA7 and SOX17 in plasma circulating tumor DNA in the early diagnosis of lung cancer

Yang Ruifei, Liu Baojing, Wu Man, Feng Feixue, Zhang Yuxin, Wang Zhanzheng, Ma Yanxia

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Journal of Chongqing Medical University ›› 2025, Vol. 50 ›› Issue (03) : 403-408. DOI: 10.13406/j.cnki.cyxb.003715
Clinical research

Application of radiological indicators combined with the methylation of HOXA7 and SOX17 in plasma circulating tumor DNA in the early diagnosis of lung cancer

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Abstract

Objective To investigate the value of diameter of pulmonary nodules，radiological indicators，serum tumor markers（CEA，CYFRA21-1，and SCC），and methylation of HOXA7 and SOX17 in circulating tumor DNA（ctDNA） in the early diagnosis of lung cancer. Methods A total of 60 patients with malignant pulmonary nodules and 60 patients with benign pulmonary nodules who were admitted to our hospital from September 2021 to December 2022 were enrolled as lung cancer group and benign nodule group，respectively，and 80 healthy individuals who underwent physical examination in our hospital during the same period of time were enrolled as control group. The three groups were compared in terms of the diameter of nodules，spiculation sign，levels of serum tumor markers，and methylation rates of HOXA7 and SOX17 in plasma ctDNA，and a multivariate regression analysis was performed to identify the independent risk factors for carcinogenesis and establish a predictive model. The receiver operating characteristic（ROC） curve was used to evaluate the diagnostic performance of the model. Results Compared with the benign nodule group and the control group，the lung cancer group had significantly higher diameter of pulmonary nodules，proportion of patients with spiculation sign，CEA，ProGRP，CYFRA21-1，and methylation rates of serum HOXA7，and SOX17，and the lung cancer group had a significantly higher level of SCC than the control group（all P<0.05）. The diameter of pulmonary nodules，spiculation sign，and methylation rates of HOXA7 and SOX17 in serum ctDNA were independent risk factors for malignant pulmonary nodules （P<0.05），and a predictive model was established as Y=ex/（1+ex ），where x=-7.233+（0.108×nodule diameter）+（3.860×spiculation sign）+（0.021×HOXA7 methylation rate）+（0.043×SOX17 methylation rate）. The predictive model had an area under the ROC curve （AUC） of 0.981，with a significantly larger AUC than each indicator alone and the Mayo and LCBP models（P<0.05）. Conclusion The diameter of pulmonary nodules，spiculation sign，and methylation rates of HOXA7 and SOX17 in ctDNA have a relatively high value in the early diagnosis of lung cancer，and the predictive model based on these indicators can significantly improve diagnostic performance.

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lung cancer / tumor markers / circulating tumor DNA / methylation

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Yang Ruifei , Liu Baojing , Wu Man , et al . Application of radiological indicators combined with the methylation of HOXA7 and SOX17 in plasma circulating tumor DNA in the early diagnosis of lung cancer. Journal of Chongqing Medical University. 2025, 50(03): 403-408 https://doi.org/10.13406/j.cnki.cyxb.003715

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