应用ROC曲线评价PET/CT联合肿瘤标志物对肺癌的诊断效能  

Evaluation of the Diagnostic Efficiency of PET/CT Imaging Plus Serum Tumor Marker Assays for Lung Cancer by Using ROC Curve

作　　者：杨彦辉[1] 邓波[1] 王如文[1] 周景海[1] 郭伟[1] 牛会军[1] 马铮[1] 康珀铭[1] 陶绍霖[1] 谭群友[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所全军胸外科研究所,重庆400042

出　　处：《肿瘤学杂志》2016年第2期110-115,共6页Journal of Chinese Oncology

摘　　要：[目的]探讨PET/CT联合血清肿瘤标志物检测在肺部良恶性占位病变的鉴别诊断价值。[方法]应用Logistic回归及ROC曲线回顾性研究228例肺部占位患者的临床资料。228例患者术前10天内完成PET/CT检查和血清肿瘤标志物(CEA、CA125、CYFRA21-1、NSE)检测,与病理结果对照,分别计算灵敏度、特异性、准确率、阳性预测值、阴性预测值;分析原发灶大小、TNM分期、病理类型与最大标准摄取值(SUV_(max))的相关性。[结果 ]病理证实184例为肺癌、44例为良性病变。肿瘤标志物诊断肺癌的灵敏度、特异性、准确率、阳性预测值、阴性预测值分别为62.0%、72.7%、64.0%、90.5%、31.3%;PET/CT分别为94.6%、50.0%、86.0%、88.8%、68.8%;两者联合诊断肺癌灵敏度、特异性、准确率、阳性预测值、阴性预测值分别为98.4%、47.7%、88.6%、88.7%、87.5%,联合组的灵敏度及阴性预测值大于PET/CT组及肿瘤标志物组(P<0.05)。应用Logistic回归及ROC曲线比较肿瘤标志物、PET/CT组、联合组的曲线下面积(AUC)分别为0.759、0.760、0.822,联合组的诊断效能高于PET/CT及肿瘤标志物组。SUV_(max)与肺癌的病灶大小呈正相关(r=0.525,P=0.000)。[结论]PET/CT联合血清肿瘤标志物检测有助于提高肺癌的诊断效能,SUV_(max)与肿瘤病灶大小呈正相关。[Purpose] To evaluate the diagnostic efficiency of positron emission tomography/computed tomography（PET/CT） plus serum tumor markers for lung cancer. [Methods] We retrospectively studied the clinical data of 228 cases with lung neoplasm. These cases underwent PET/CT and serum tumor markers（CEA,CA125,CYFRA21-1,NSE） inspections within ten days prior to the operations. The sensitivity,specificity,accuracy,positive predictive value（PPV） and negative predictive value（NPV） and correlations between clinicopathologic features and standard uptake value in maximum（SUVmax） were evaluated,respectively. [Results] A total of 184 patients and 44 patients were diagnosed as lung cancer and benign lung diseases,respectively. With regard to lung cancer,the sensitivity,specificity,accuracy,PPV,NPV of the serum tumor markers and PET/CT were 62.0% vs 94.6%,72.7% vs 50.0%,64.0% vs 86.0%,90.5% vs 88.8% and 31.3%vs 68.8%,respectively. Interestingly,the sensitivity,specificity,accuracy,PPV and NPV by using tumor markers plus PET/CT were 98.4%,47.7%,88.6%,88.7%,87.5%. Sensitivity and NPV of the combination group were significantly higher than sole use of serum tumor markers or PET/CT（P0.05）. Area under the ROC curve（AUC） of serum tumor markers,PET/CT and their combination were 0.759,0.760 and 0.822,respectively. SUVmaxwas significantly associated with tumor size（r=0.525,P=0.000）. [Conclusion] The combined use of PET/CT and serum tumor markers is contributive to the diagnosis of lung cancer,SUVmaxis significantly associated with tumor size.

关 键 词：正电子发射计算机断层显像/计算机体层成像 肿瘤标志物 肺肿瘤 ROC曲线 

分 类 号：R734.2[医药卫生—肿瘤]