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1、应用ROC曲线评价肿瘤标记物联合检测对常见癌症的诊断效果刘曰旭刘希龙王亚男(大连大学附属新华医院检验科116021}【摘要】目的：分析癌症患者肿瘤标记物浓度水平和诊断价值，并应用受试者工作特性(ROC)曲线确定肿瘤标记物联合检测的诊断阈值，评价诊断效果。方法：采集90例癌症患者和40例健康体检者空腹血，检测甲胎蛋白(AFP)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)、癌胚抗原(CEA)、细胞角蛋019(CYFRA21-1)、铁蛋白(FER)、神经元特异烯醇化酶(NSE)的血清水平，选取两组屮
2、具有非常显著的统计学意义差异(P<0.01)的项目应用SPSS19.0软件绘制ROC曲线，确定联合检测的诊断阈值，通过ROC曲线T面积(AUC)来评价肿瘤标志物联合检测的诊断效果。结果：AFP、CA125、CA72-4、CEA、CYFRA21-1高于正常对照组(P<0.01),以大于正常对照组屮值为阳性条件绘制ROC曲线，AUC=0.80，当诊断阈值为阳性数2.5时，敏感度为65.6%,特异性为82.5%,均较高。结论：癌症患者伴有肿瘤标志物指标的不同程度的变化，AFP、CA125、CA72-4、CEA、CYFRA21-1联合检测可能
3、提高常见癌症的诊断效果。【关键词】癌症肿瘤标志物ROC曲线早期诊断【屮图分类号】R730.14【文献标识码】A【文章编号】1672-5085(2014)09-0143-02EvaluationoftheDiagnosticEffectsintheCommonCancersBasedontheCombinedDetectionofTumormarkerswithROCcurveLiuRixu,LiuXilong,WangYanan116021,Dalian,XinhuaHospitalAffiliatedtoDalianUniversity,Cli
4、nicallaboratory【Objective】Toanalyzethelevelsanddiagnosticvalueofdetectingindicatorsoftumormarkerstestincancerpatients,thediagnosticcutoffvalueofthecombineddetectionoftumormarkerswasconfirmedwithROCcurve,thediagnosticeffectinthecommoncancersbasedonthecombineddetectionwasevalua
5、ted.Methods:Wecollectedthefastingbloodof90casescancerpatientsand40casespeopleconductedhealthexamination.AFP,CA125,CA19-9,CA72-4,CEA,CYFRA21-1,FER,NSEweredetectedbyRocheE411electrochemicalimmunodetectionanalyzerwithintravenousserum.ROCcurveweredrawnwiththeselectedindicatorswit
6、haverysignificantstatisticaldifference(P<0.01)inthetwogroupsbySPSS19.0software.ThediagnosticcutoffvalueofthecombineddetectionoftumormarkerswasconfirmedwithROCcurveandthediagnosticeffectsofindicatorswereevaluatedwithAUC.Results:ThelevelsofAFP,CA125,CA72-4,CEA,CYFRA21-1incan
7、cergroupweremorethanthoseinthenormalcontrolgroup(P<0.01).Withthecorrespondingmediansofthenormalcontrolgroupasreference,combineddetectionofAFP,CA125,CA72-4,CEA,CYFRA21-1,AUCwas0.80.Whenthecutoffvaluewas2.5positiveitems,thesensitivitywas65.6%andthespecificitywas82.5%,respect
8、ivelyinahigherlevel.Conclusion:Therewerevariationsinindicatorsoftumo
