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-Ag)和铁蛋白(SF)经Logistic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受试者的SCC-Ag进行测定,采用免疫比浊法对受试者的SF进行测定,并对其进行Logistic回归及ROC曲线综合分析。结果:与对照组相比,肺癌组3种肿瘤标志物CEA、SCC-Ag及SF水平均明显升高且差异具有统计学意义(P<0.01)。腺癌组患者CEA水平明显高于鳞癌组及小细胞癌组且差异具有统计学意义(P<0.01),鳞癌患者SCC-Ag水平明显高于腺癌和小细胞癌患者且差异具有统计学意义(P<0.01),而3种病理类型肺癌患者间SF水平差异无统计学意义(F=0.529,P>0.05)。与Ⅰ+Ⅱ分期相比,Ⅲ+Ⅳ分期3种肿瘤标志物CEA、SCC-Ag及SF明显升高且差异具有统计学意义(P<0.05或<0.01)。以对照组为参照,CEA、SCC-Ag、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3项联合检测的敏感性为89.9%,特异性为75.9%。Logistic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,Y的ROC曲线的面积AUC明显大于3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-Ag和SF 3项指标对肺癌诊断意义重大,同时借助Logistic回归及ROC曲线分析有助于提高诊断的准确性。
Objective： To discuss the diagnostic value of serum carcinoembryonic antigen（ CEA）,squamous cell carcinoma antigen（ SCC-Ag） and serum ferritin（ SF） in lung cancer analyzed with ROC curve and Logistic regression. Methods： The CEA of the subjects were measured by the electrochemical luminescence instrument,enzyme linked immunosorbent assay was used to determine the SCC-Ag of the subjects,the SF of the subjects were tested by the method of immune turbidity,and the Logistic regression and ROC curve analysis were used to analyze CEA,SCC-Ag and SF. Results： Compared with the control group,the levels of SF,SCC-Ag and CEA of the three tumor markers in lung cancer group were significantly higher（ P 〈 0. 01）. The levels of CEA of gland cancer patients were significantly higher than those in patients with scales and small cell carcinoma group and the differences were significant with statistical significance（ P 〈 0. 01） and SCC levels in patients with squamous cell carcinoma were significantly higher than those of adenocarcinoma and small cell lung cancer patients and the differences were statistically significant（ P 〈 0. 01）,and the differences of SF levels among three pathological types of lung cancer patients were not significantly（ F = 0. 529,P 〉 0. 05）. Compared with Ⅰ ＋ Ⅱ stage,the levels of three tumor markers SF,SCC-Ag and CEA were significantly higher（ P 〈 0. 05 or 〈 0. 01）. In the control group as a reference,CEA,SCC-Ag and SF sensitivity for lung cancer were 46. 5%,46. 5% and 70. 0% and specificity were 93. 1%,96. 6%,86. 6%,and the sensitivity of combined detection was 89. 9%,specificity was 75. 9%. By Logistic regression analysis,CEA,SCC-Ag and SF of the three tumor markers were closely related to the diagnosis of lung cancer（ P 〈 0. 01）. Statistical analysis showed that the area under the curve（ AUC） was significantly larger than AUC of any of the three tumor markers（ CEA,SCC-Ag and SF）. Conclusion： The combined detection of serum CEA,SCC-Ag and SF has a good value in the diagnosis of lung cancer,using Logistic regression and ROC curve analysis can improve the accuracy of diagnosis of lung cancer.
出处
《现代医学》
2016年第10期1378-1382,共5页
Modern Medical Journal
