应用ROC曲线评价CYFRA21-1与CEA联合检测对肺癌的诊断价值  

Application of ROC Curve in the Analysis and Evaluation of the Diagnostic Value of the Combined Detection of CYFRA21-1 and CEA in Lung Cancer

作　　者：张亚松[1] 石玉玲[1] 肖登岩[1] 何志东[1] 

机构地区：[1]广州军区总医院检验科,广东广州510010

出　　处：《医学临床研究》2007年第7期1081-1083,共3页Journal of Clinical Research

摘　　要：【目的】探讨细胞角蛋白19片段(CYFRA21-1)和癌胚抗原(CEA)联合检测对肺癌的诊断价值。【方法】应用受试者工作特性曲线(ROC)对72例肺癌患者、29例肺部良性疾病患者以及44例健康体检者的CYFRA21-1、CEA以及两者联合检测结果进行分析评价。【结果】①肺癌组血清CEA与CYFRA21-1水平显著高于肺良性疾病组以及正常对照组(P<0.01),二者在肺良性疾病组与正常对照组无差异(P>0.05)。②根据ROC曲线分析,CYFRA21-1、CEA对肺癌的临床诊断临界点分别为3.25μg/L,5.08μg/L。③肺癌组的CYFRA21-1、CEA以及两者联合检测在ROC曲线下的面积(AUC)分别为0.83、0.78、0.91。④CY-FRA21-1和CEA在肺癌组的灵敏度分别为59.72%、52.78%,CYFRA21-1在肺鳞癌中灵敏度最高为72.73%,CEA在肺腺癌中最高为67.86%。两者联合检测的灵敏度明显提高为81.94%。【结论】CYFRA21-1和CEA联合检测可显著提高肺癌诊断的灵敏度和有效性,优于CYFRA21-1、CEA的单项检测。[Objective]To investigate the diagnostic value of the serum Cytokeratin-19fragment（CYFRA21-1）,Carcinoembryonic antigen（CEA）and the combined detection CYFRA21-1 and CEA in lung cancer.[Methods]ROC curve was used to analyse the results about CYFRA21-1,CEA from 72 patients with lung cancer、42 benign pulmonary diseases and 30 normal subjects.[Results] ①The level of CYFRA21-1and CEA of lung cancer group was significantly higher than of the benign group and control group,there was no notable difference between the benign group and control group.②According to the ROC,the clinical diagnostic critical point of CYFRA21-1and CEA in patients with lung cancer were 3.25ug/L and 5.08ug/L.③ROC curve showed that the under-curve area（AUC） of CYFRA21-1,CEA,CYFRA21-1and CEA were0.803、0.764、0.910 respectively.All results showed satisfied diagnostic effect.④The sensitivity of CYFRA21-1 and CEA was 59.72% and 52.78% respectively.In squamous cell carcionmas,CYFRA21-1 showed the highest sensitivity about 72.73%,in adenocarcinomas CEA highest sensitivity about 67.86%.The combined detection of two tumor markers should improve the sensitivity for lung cancer up to 81.94%.[Conclusion]ROC analysis shows that the sensitivity and utility could be increased by combined CYFRA21-1 and CEA in diagnosis of lung cancer,it is better than CYFRA21-1 or CEA individual detection.

关 键 词：肺肿瘤/诊断 角蛋白/分析 癌胚抗原/分析 

分 类 号：R734.2[医药卫生—肿瘤]