结合小类配平法的Logistic回归提高大肠肿瘤筛查效果的研究  

Application of logistic regression with rare class balancing method in colorectal neoplasm screening

作　　者：蔡善荣[1] 黄彦钦[1] 阮红芳[2] 张苏展[1] 郑树[1] 

机构地区：[1]浙江大学医学院附属第二医院肿瘤研究所教育部恶性肿瘤干预与预警重点实验室,浙江杭州310009 [2]浙江大学医学院附属第二医院门诊部,浙江杭州310009

出　　处：《实用肿瘤杂志》2015年第6期553-556,共4页Journal of Practical Oncology

基　　金：浙江省医药卫生科技计划项目(2013KYA091)

摘　　要：目的研究结合小类配平法的Logistic回归能否提高大肠肿瘤筛查的效益。方法通过增加病例样本量,均衡病例与对照样本比例后对浙江嘉善的6个乡镇筛查人群结果进行结合小类配平法的Logistic回归分析,并在另一筛查乡镇(天凝镇)的人群中验证结合小类配平法的Logistic回归对大肠肿瘤筛查的效益。结果 6个乡镇在病例对照样本明显不均衡(病例为对照的4.7%,即进展期肿瘤样本为非进展期肿瘤样本量的4.7%)的情况下,进展期肿瘤的分类准确率(敏感度)为0.1%,而非进展期肿瘤的分类准确率为99.9%。将小类病例样本数复制扩增,随着两类样本数量逐渐接近,进展期肿瘤判断准确率相应上升。病例和对照样本比例为1.1时,进展期肿瘤的敏感度提高至82.2%,特异度为46.5%。在验证的天凝镇人群中同样发现,在病例和对照样本比例为0.7时,进展期肿瘤的敏感度为64.6%,特异度为63.6%;病例复制后与对照样本比例提高至1.3,敏感度提高至89.7%,而特异度降至30.6%。结论初步研究表明,通过结合小类配平法的Logistic回归能够显著提高大肠肿瘤筛查中对进展期肿瘤的敏感度,从而提高筛查效益。Objective To apply logistic regression with rare class balancing method in colorectal neoplasm screening. Methods With rare class balancing methods,duplicated cases were added to case samples to weight case and control sample size in logistic regression. The colorectal neoplasm screening results in 6 communities in Jiashan county were analyzed and reevaluated in another community in Jiashan county,and the effectiveness of logistic regression with rare class balancing methods in screening was verified. Results The sensitivity of advancing colorectal neoplasm and the specificity was 0. 1% and 99. 9% respectively,while case sample size was 4. 7% of control sample size. When the ratio of case sample to control sample reached 1. 1 by adding duplicated cases,the sensitivity of advancing colorectal neoplasm was increased to82. 2% and the specificity was decreased to 46. 5%. In the community for reevaluation,with the ratio of case sample to control sample increased from 0. 7 to 1. 3,the sensitivity was increased from 64. 6% to 89. 7%,while the specificity was decreased from 63. 6% to 30. 6%. Conclusion Applying logistic regression with rare class balancing method in colorectal neoplasm screening improves the sensitivity of advancing colorectal neoplasm and screening effectiveness.

关 键 词：肠肿瘤 LOGISTIC模型 普查 

分 类 号：R735.34[医药卫生—肿瘤]