Logistic回归和ROC曲线评价癌胚抗原鳞状细胞癌抗原和铁蛋白对肺癌诊断价值.docVIP

Logistic回归和ROC曲线评价癌胚抗原鳞状细胞癌抗原和铁蛋白对肺癌诊断价值 　　[摘要] 目的 探讨Logistic回归和ROC曲线综合分析血清癌胚抗原（CEA）、鳞状细胞癌抗原（SCC）和铁蛋白（SF）对肺癌的诊断价值。 方法 采用电化学发光法检测CEA，酶联免疫吸附测定法检测SCC，免疫比浊法检测SF，检测100例肺癌患者（肺癌组）和30例健康者（健康组）血清中的CEA、SCC、SF水平，通过Logistic回归建立回归模型，用ROC曲线分析三种肿瘤标志物对肺癌的诊断的意义。 结果 肺癌组CEA、SCC、SF水平显著高于健康组[（13.82±21.42）μg/L比（2.79±1.39）μg/L；（3.93±7.58）μg/L比（0.76±0.28）μg/L；（455.31±271.38）μg/L比（148.50±97.30）μg/L，均P 0.01]，腺癌患者CEA水平[（26.42±28.97）μg/L]最高，鳞癌患者SCC水平[（8.01±11.32）μg/L]最高，肺癌患者三种肿瘤标志物水平与TNM分期密切相关，（Ⅲ+Ⅳ）期明显高于（Ⅰ+Ⅱ）期[（15.17±23.20）μg/L比（8.72±11.70）μg/L；（4.57±8.42）μg/L比（1.53±0.86）μg/L；（479.08±280.72）μg/L比（365.90±215.86）μg/L，P 0.05或P 0.01]，分期越晚，三种肿瘤标志物水平越高。建立回归模型Y=1/[1+EXP（2.261X1+3.459X2+4.267X3-1.082）]，新变量Y的AUC高于三种单一肿瘤标志物的AUC。 结论 血清CEA、SCC和SF对肺癌的诊断具有较高的价值，联检可提高对肺癌的诊断率，综合运用Logistic回归和ROC曲线分析可提高肺癌诊断的准确性。 　　[关键词] 肺癌；癌胚抗原；鳞状细胞癌抗原；铁蛋白 　　[中图分类号] R734.2[文献标识码] A[文章编号] 1673-7210（2014）06（a）-0016-04 　　 　　Diagnostic value of serum CEA, SCC and SF in lung cancer analyzed with ROC curve and Logistic regression 　　LI Peizhang1 ZHU Bo1 WANG Ying1 HUANG Lingsha1 HUANG Wencheng1 LAO Ming1 LUO Jiening2 MAO Naiquan2 　　1.Department of Laboratory, Guangxi Cancer Institute, Guangxi Zhuang Autonomous Region, Nanning 530021, China; 2.Department of Thoracic Surgery, Guangxi Cancer Institute, Guangxi Zhuang Autonomous Region, Nanning 530021, China 　　[Abstract] Objective To investigate the diagnostic value of serum CEA, SCC and SF as analyzed with Logistic regression and ROC curve in patients with lung cancer. Methods Serum CEA, SCC and SF were measured in 100 patients with lung cancer (lung cancer group) and 30 healthy subjects (healthy group). Logistic regrssion and ROC curve were applied to analyze the data and evaluate the diagnostic values. Results The concentration of serum CEA, SCC and SF in lung cancer group were significantly higher than the healthy group [(13.82±21.42) μg/L vs (2.79±1.39) μg/L; (3.93±7.58) μg/L vs (0.76±0.28) μg/L; (455.31±271.38) μg/L vs (148.50±97.30) μg/L, P 0.01]. The serum level of CE