ROC曲线评价TSGF、LDH、CA125、SF辅助淋巴瘤诊断的效能  

The diagnostic efficacy of TSGF,LDH,CA125 and SF in diagnosis of lymphoma evaluated by ROC curve

作　　者：刘文丹[1] 邹琰 杜伟峰[1] LIU Wendan;ZOU Yan;DU Weifeng(Medical Examination Department,The Second Affiliated Hospital of Guangzhou Medical University,Guangdong,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院体检科,广州市510260

出　　处：《河北医药》2022年第21期3251-3254,共4页Hebei Medical Journal

基　　金：广州市科技计划项目(编号:201707010366)。

摘　　要：目的探讨肿瘤特异性生长因子(TSGF)、乳酸脱氢酶(LDH)、糖类抗原125(CA125)、血清铁蛋白(SF)联合检测对淋巴瘤早期诊断的临床价值和效果。方法选取2017年1月至2018年3月门诊及住院患者107例(淋巴瘤组)及133例体检中心健康对照标本(健康对照组),采用电化学发光法检测血清中TSGF、LDH、CA125、SF浓度水平,MedCale软件进行ROC曲线分析,以尤登指数最大为阳性判断值,通过比较AUC分析单/多指标联合辅助淋巴瘤诊断的效能。结果淋巴瘤组TSGF、LDH、CA125、SF水平均高于健康对照组(P<0.05)。ROC分析显示,最佳阳性截断值TSGF为>52 U/ml(敏感度为86.71%,特异度为65.80%)、LDH为>178 U/L、(敏感度为79.37%,特异度为75.91%)CA125为>31.2 U/ml、(敏感度为73.92%,特异度为73.18%)SF为>208μg/L(敏感度为84.72%,特异度为68.76%)。TSGF、LDH、CA125、SF三项/四项联合辅助淋巴瘤诊断,AUC比各单项应用均有增加(P<0.01),但TSGF+LDH+SF三项联合与四项组合比较,AUC无显著性差异(P>0.05)。三项指标联合应用组间比较,TSGF+LDH+SF为最佳组合。不同病理类型的淋巴瘤辅助诊断效能比较,CA125辅助非霍奇金淋巴瘤(AUC=0.921)的效能最佳。结论TSGF、LDH、CA125、SF多指标联合辅助诊断效能高于单指标,对于不同病理类型淋巴瘤的辅助诊断有一定针对性,推荐四项联合检测辅助淋巴瘤诊断。Objective To investigate the clinical significance of combined detection of tumor specific growth factor(TSGF),lactate dehydrogenase(LDH),cancer antigen 125(CA125),serum ferritin(SF)in early diagnosis of lymphoma.Methods A total of 103 patients with lymphoma who were treated in our hospital from January 2017 to March 2018 were enrolled as lymphoma group,and the other 133 healthy subjects were enrolled as control group.The serum levels of TSGF,LDH,CA125,SF were detected by electro-chemical immunoassay.The area under the ROC curve(AUC),sensitivity,specificity and Youden’s index were calculated by Med Calc software.The efficacy of AUC in diagnosis of lymphoma was analyzed by comparing single/multi indexes combination detection.Results The serum levels of TSGF,LDH,CA125 and SF in lymphoma group were significantly higher than those in control group(P<0.05).ROC analysis showed that the optimized positive cutoff value of TSGF was>52U/ml,with sensitivity and specificity being 86.71%and 65.80%,respectively,which of LDH was>178U/L,with sensitivity and specificity being 79.37%and 75.91%,respectively,which of CA125 was>31.2U/ml,with sensitivity and specificity being 73.92%and 73.18%,respectively,which of SF was>208μg/L,with sensitivity and specificity being 84.72%and 68.76%,respectively.Moreover the combination detection of the three indexes or the four indexes could increase AUC significantly(P<0.01).TSGF+LDH+SF was the best combination,and the adjuvant diagnostic efficacy of CA125 was the best in diagnosis of Non-Hodgkin’s lymphomas(AUC=0.921).Conclusion The adjuvant diagnostic efficacy of combination detection of TSGF,LDH,CA125,SF is higher than that by simple indxes detection,and the combination detection of the four indexes is recommended.

关 键 词：淋巴瘤 肿瘤特异性生长因子 乳酸脱氢酶 糖类抗原125 血清铁蛋白 ROC曲线 

分 类 号：R733.41[医药卫生—肿瘤]