摘要
目的:探讨肿瘤标志物(TM)癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原CA72-4(CA72-4)、糖类抗原CA19-9(CA19-9)在胃结肠肿瘤诊断中的应用价值.方法:应用电化学发光免疫法测定106例胃结肠肿瘤、111例胃结肠良性病、92例正常对照血清中CEA,AFP,CA72-4和CA19-9水平,通过ROC曲线分析和逐步logistic回归结果的ROC曲线下面积(AUC),对TM单独及不同组合方式的敏感性、特异性、Youden指数和阳性似然比/阴性似然比进行比较分析.结果:各TM在胃结肠肿瘤组的浓度显著高于胃结肠病良性病组和正常对照组.胃结肠良性病-胃结肠恶性肿瘤中,逐步Logistic回归法模拟变量的AUC高于单一TM的AUC.CA72-4,CEA,CA19-9联合应用的敏感性、Youden指数、阳性似然比/阴性似然比最高.结论:基于logistic回归的ROC分析可以改善诊断的准确性.在胃结肠肿瘤的鉴别诊断中,CA72-4,CEA及CA19-9联合分析是较好组合.
AIM： To investigate the diagnostic values of tumor markers（ CEA, AFP, CA72-4 and CA19-9 ） for gastrocolic tumors by receiver operating characteristic （ROC） curve and stepwise logistic regression（LR） analysis. METHODS ： The serum concentrations of CEA,AFP, CA72-4 and CA19-9 were measured with electrochemil immunoassay in 106 patients with gastrocolic tumors, 111 patients with benign gastrocolic disorders and 92 controls. The area under the ROC curve（AUC）of CEA,AFP, CA72-4 and CA19-9 and stepwise LR results were compared by sensitivity, specificity, Youden＇s index and positive likelihood ratio/ negative likelihood ratio. RESULTS ： The four tested tumor markers in patients with gastrocolic tumor were significantly higher than those in benign gastrocolic group and normal controls. In the tumor-benign group, the AUC from stepwise logistic regression was larger than the AUC of four tumor markers respectively. Sensitivity ,Youden＇s index and positive likelihood ratio/negative likelihood ratio of CA72-4, CEA, CA19-9 were the highest in various combination manners of the four tumor markers. CONCLUSION： The use of ROC established by LR analysis improves diagnostic accuracy. The combination of tumor markers CA72-4, CEA and CA19-9 is more suitable as a diagnostic model for the screening of gastrocolic tumor.
出处
《第四军医大学学报》
北大核心
2008年第14期1298-1300,共3页
Journal of the Fourth Military Medical University
