CEA、CY211、NSE、Ca125联合诊断肺癌的ROC曲线分析  

ROC curve analysis of CEA,CY211,NSE and CA125 in the diagnosis of lung cancer

作　　者：龚岚[1] 罗晓云[1] Gong Lan;Luo Xiaoyun(Department Clinical Laboratory,Wuxi Second People′s Hospital,Wuxi,214000,China)

机构地区：[1]无锡市第二人民医院检验科,江苏214000

出　　处：《中华肺部疾病杂志（电子版）》2020年第6期777-780,共4页Chinese Journal of Lung Diseases(Electronic Edition)

基　　金：南京医科大学科技发展基金重点项目(2017NJMUZD113)。

摘　　要：目的探讨癌胚抗原(CEA)、细胞角蛋白19片段(CY211)、神经元特异性烯醇化酶(NSE)、糖类抗原125(CA125)联合用于肺癌诊断的价值。方法选取我院2018年10月至2019年6月收治的肺癌患者140例作为肺癌组,选取同期收治的良性肺病患者136例作为对照组。比较两组血清CEA、CY211、NSE、CA125水平,绘制受试者工作特征曲线(ROC)分析各指标单独与联合检测对肺癌的诊断价值,确定曲线下面积(AUC)、最佳界值与相应的灵敏度、特异度。以病理诊断为金标准,经Kappa检验分析四项指标联合诊断肺癌与病理诊断的一致性,并分析灵敏度、特异度、符合率、阳性预测值、阴性预测值。结果肺癌组血清CEA、CY211、NSE、CA125含量显著高于对照组(P<0.05)。血清CEA、CY211、NSE、CA125含量诊断肺癌的AUC分别为0.773、0.762、0.753、0.801,四项联合诊断的AUC为0.906。以血清CEA>7.965 ng/ml、CY211>7.960 ng/ml、NSE>28.025 ng/ml、CA125>22.065 U/ml时,发生肺癌风险越高。以病理诊断为金标准,提示四项指标联合诊断肺癌的灵敏度为90.00%,特异度为91.18%,符合率为90.58%,阳性预测值为90.00%,阴性预测值为91.18%,经Kappa检验其与病理诊断一致性为0.812(高度一致性)。结论与肺良性病者相比,肺癌患者的血清CEA、CY211、NSE、CA125含量明显增高,且四者均对肺癌诊断具有一定价值,四项联合诊断的效果最佳,与病理诊断一致性较好。Objective To explore the value of CEA,cy211,NSE and CA125 in the diagnosis of lungcancer.Methods 140 patients with lung cancer admitted to our hospital from October 2018 to June 2019 wereselected as the lung cancer group,and 136 patients with benign lung disease admitted to our hospital during thesame period were selected as the control group.The serum CEA,cy211,NSE and CA125 levels of the twogroups were compared,and the working characteristic curve(ROC)of the subjects was drawn to analyze thediagnostic value of each index for lung cancer,and the area under the curve(AUC),the best boundary value,the corresponding sensitivity and specificity were determined.With pathological diagnosis as the gold standard,Kappa test was used to analyze the consistency between the combined diagnosis of lung cancer and pathologicaldiagnosis of the four indicators,as well as the sensitivity,specificity,Coincidence rate,positive predictivevalue and negative predictive value.Results Serum CEA,CY211,NSE and CA125 levels in lung cancergroup were significantly higher than those in control group(P<0.05).The AUC of serum CEA,cy211,NSEand CA125 were 0.773,0.762,0.753 and 0.801,respectively.The AUC of combined diagnosis was 0.906.When CEA>7.965 ng/ml,cy211>7.960 ng/ml,NSE>28.025 ng/ml,CA125>22.065 U/ml,the higher therisk of lung cancer.Pathological diagnosis was taken as the gold standard,suggesting that the sensitivity,specificity and coincidence rate of the combined diagnosis of lung cancer with the four indicators were 90.00%,91.18%and 90.58%,respectively.The positive predictive value and negative predictive value were 90.00%and 91.18%respectively,and the consistency between them and the pathological diagnosis by Kappa test was0.812(highly consistent).Conclusion Compared with patients with benign lung diseases,serum CEA,CY211,NSE and CA125 in patients with lung cancer were significantly increased,and all the four patients hadcertain value in lung cancer diagnosis.

关 键 词：支气管肺癌 癌胚抗原 细胞角蛋白19片段 神经元特异性烯醇化酶 糖类抗原CA125 

分 类 号：R734.2[医药卫生—肿瘤]