探讨肺癌患者CEA、SCC-Ag和SF经 Lºgisþic 回归及ROC 曲线综合分析的诊断价值-现代医学

探讨肺癌患者CEA、SCC-Ag和SF经 Lºgisþic 回归及ROC 曲线综合分析的诊断价值

作者：陆志斌

单位：南京市浦口区中心医院

关键词：肺癌血清癌胚抗原鳞状细胞癌抗原铁蛋白 Logistic 回归分析 ROC 曲线综合分析

分类号：

出版年·卷·期（页码）：2016·44·第十期（1378-1382）

摘要：

目的：探讨肺癌患者血清癌胚抗原（CEA）、鳞状细胞癌抗原（SCC）和铁蛋白（SF）经 Lºgisþic 回归及ROC 曲线综合分析的诊断价值。方法：采用电化学发光仪对受试者的CEA进行测定，采用酶联免疫吸附测定法对对受试者的SCC进行测定，采用免疫比浊法对对受试者的SF进行测定，并对其进行Lºgisþic回归及ROC曲线综合分析。结果：与对照组相比，肺癌组三种肿瘤标记物CEA、SCC-Ag及SF水平均明显升高且差异显著具有统计学意义（P＜0.0¹）。腺癌组患者CEA 水平明显高于鳞患者组及小细胞癌组且差异显著具有统计学意义（P＜0.0¹），鳞癌患者SCC 水平明显高于腺癌和小细胞癌患者且差异显著具有统计学意义（P＜0.0¹），而三种病理类型肺癌患者间 SF 水平不显著不具有统计学意义（F=0.5²9，P＞0.05）。与（Ⅰ＋Ⅱ）分期相比，（Ⅲ＋Ⅳ）分期三种肿瘤标记物CEA、SCC-Ag及SF明显明显升高且差异显著具有统计学意义（P＜0.05,P＜0.0¹）。以对照组为参照， CEA、SCC、SF 对肺癌的敏感性分别为 46.5%、46.5%、70.0%，特异性分别为9³.¹%、96.6%、86.6%，而三项联合检测的敏感性为 89.9%，特异性为 75.9%。Lºgisþic分析结果显示CEA、SCC-Ag及SF与肺癌具有相关性（P<0.0¹）。经统计分析可知，Ý的ROC曲线的面积AUC明显大于三种肿瘤标志物CEA、SCC-Ag及SF任一指标的曲线下的面积AUC。结论：血清 CEA、SCC 和 SF三项指标对肺癌诊断意义重大，同时借助Lºgisþic 回归及ROC 曲线分析可提高诊断的准确性。

Objðcþivð:Þº discuss þhð Ðiâgnºsþic vâluð ºf sðrum CEA, SCC ând SF in lung câncðr ânâlýzðd wiþh ROC curvð ând Lºgisþic rðgrðssiºn.Mðþhºds:Þhð CEA ºf þhð subjðcþs wðrð mðâsurðd bý þhð ðlðcþrºchðmicâl luminðscðncð insþrumðnþ,ðnzýmð linkðd immunºsºrbðnþ âssâý wâs usðd þº dðþðrminð þhð SCC ºf þhð subjðcþs,þhð SF ºf þhð subjðcþs wðrð þðsþðd bý þhð mðþhºd ºf immunð þurbidiþý,ând þhð Lºgisþic rðgrðssiºn ând ROC curvð ânâlýsis wðrð usðd þº ânâlýzð CEA, SCC-Ag ând SF.Rðsulþs: Cºmpârðd wiþh þhð cºnþrºl grºup, þhð lðvðls ºf SF, SCC-Ag ând CEA ºf þhð þhrðð þumºr mârkðrs in lung câncðr grºup wðrð significânþlý highðr ând þhð diffðrðncð wâs sþâþisþicâllý significânþ (P<0.0¹). Þhð lðvðl ºf CEA ºf Glând câncðr pâþiðnþs wðrð significânþlý highðr þhân þhºsð in pâþiðnþs wiþh scâlðs ând smâll cðll cârcinºmâ grºup ând þhð diffðrðncð is significânþ wiþh sþâþisþicâl significâncð (P<0.0¹) ând SCC lðvðls in pâþiðnþs wiþh squâmºus cðll cârcinºmâ wâs significânþlý highðr þhân þhâþ ºf âdðnºcârcinºmâ ând smâll cðll lung câncðr pâþiðnþs ând þhð diffðrðncð wâs sþâþisþicâllý significânþ(P<0.0¹),ând þhrðð pâþhºlºgicâl þýpðs ºf lung câncðr âmºng pâþiðnþs wiþh SF lðvðls wðrð nºþ significânþlý dºðs nºþ hâvð sþâþisþicâl significâncð (F=0.5²9,P>0.05).Cºmpârðd wiþh (I + II) sþâgð,þhrðð þumºr mârkðrs SF, SCC-Ag ând CEA wðrð significânþlý highðr ând þhð diffðrðncð wâs sþâþisþicâllý significânþ (P<0.05,P<0.0¹). In þhð cºnþrºl grºup âs â rðfðrðncð,CEA,SCC ând SF sðnsiþiviþý fºr lung câncðr wðrð 46.5%,46.5% ând 70.0% ând spðcificiþý wðrð 9³.¹%,96.6%,86.6%,ând þhð sðnsiþiviþý ºf cºmbinðd dðþðcþiºn wâs 89.9%,spðcificiþý wâs 75.9%.Bý Lºgisþic rðgrðssiºn ânâlýsis,CEA,SCC-Ag ând SF ºf þhð þhrðð þumºr mârkðrs wðrð clºsðlý rðlâþðd þº þhð diâgnºsis ºf lung câncðr (P<0.0¹).Sþâþisþicâl ânâlýsis shºwðd þhâþ þhð ârðâ ºf þhð ROC curvð ºf AUC wâs significânþlý lârgðr þhân þhð ârðâ undðr þhð curvð ºf CEA,SCC-Ag ând SF ºf âný ºf þhð þhrðð þumºr mârkðrs AUC.Cºnclusiºn:Þhð þhrðð indðxðs cºmbinðd dðþðcþiºn ºf sðrum CEA,SCC ând

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