摘要
目的:应用Logistic回归和ROC曲线探讨CEA、CA199及CA50在结直肠癌诊断中的应用价值。方法:结直肠癌患者75例,良性结直肠病患者35例,正常人49例,分别应用化学发光免疫分析测定CEA,电化学发光免疫分析测定CA199,免疫放射分析测定CA50,通过ROC曲线分析CEA、CA199、CA50及各种Logistic回归结果的ROC曲线下面积(AUC)。结果:结直肠癌-良性结直肠病中,CA50的AUC要高于CA199的AUC,而CEA、CA50两项联合诊断结直肠癌的AUC(0.875)要高于CEA、CA199、CA50三项联合诊断的AUC(0.604),且CEA、CA50两项联检诊断的AUC高于CEA、CA199或CA50任意单一检查的AUC。在结直肠癌-正常对照组中,三项肿瘤标志物联检的AUC(0.866)均高于三项肿瘤标志物单一检查的AUC,无论在结直肠癌-正常对照组中还是结直肠癌-良性结直肠病中CEA的AUC都高要于CA199或CA50。结论:CEA在诊断结直肠癌有一定的临床应用价值,CA50联合CEA检测可为临床鉴别良恶性结直肠病提供有效的参考,而CEA、CA199及CA50三者联检对鉴别良恶性结直肠病的意义不大。作为一种统计手段,Logistic回归可改善诊断的灵敏度和特异性。
Objective To assess the diagnostic value of CEA, CA199 and CA50 for colorectal neoplasm by logistic regression and ROC curve. Methods Serum CEA （with CLIA）, CA199 （with ECLIA） and CA50 （with IRMA） levels were measured in 75 patients with colorectal cancer, 35 patients with benign colorectal disorders and 49 controls. The area under the ROC curve （AUC）s of CEA, CA199, CA50 from logistic regression results were compared. Results In the cancer - benign disorder group, the AUC of CA50 was larger than the AUC of CA199. AUC of combined CEA, CA50 was largest： not only larger than any AUC of CEA, CA50, CA199 alone but also larger than the AUC of the combined three marders （0. 875 vs 0. 604）. In cancer - control group, the AUC of combination of CEA, CA199 and CA50 was larger than any AUC of CEA, CA199 or CA50 alone. Both in the cancer - benign disorder group or cancer - sontrol group, the AUC of CEA was larger than the AUC of CA199 or CA50. Conclusion CEA is of definite value in the diagnosis of colorectal cancer. For differential diagnosis, the combination of CEA and CA50 can give more information, while the combination of three tumor markers is less helpful. As an advanced statistical method, logistic regression can improve the diagnostic sensitivity and specificity.
出处
《放射免疫学杂志》
CAS
2007年第3期202-205,共4页
Journal of Radioimmanology
基金
国家自然科学基金资助项目(30470497)
上海市科委重点基金资助项目(02DJ04137)
