血清CA72-4、CA242、CA19-9和CEA的PLS-DA模型对胃癌的诊断价值
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摘要
目的探讨联合检测血清CA72-4、CA242、CA19-9和癌胚抗原(CEA)对胃癌的诊断价值。方法采用电化学发光法测定193例胃癌患者、106例胃良性疾病患者和86例健康对照者血清CA72-4、CA242、CA19-9和CEA水平,进行单因素方差分析、Logistic回归-ROC曲线和偏最小二乘-判别分析(PLS-DA)。结果Ⅰ~Ⅱ期胃癌组患者血清CA242和CEA水平显著高于良性疾病组和健康对照组(P<0.05)。胃癌组Ⅲ~Ⅳ期患者血清CA72-4、CA242、CA19-9和CEA水平显著高于Ⅰ~Ⅱ期、良性疾病组和健康对照组(P<0.01)。4种标志物联合的Logistic回归-ROC曲线下面积为0.956(95%置信区间:0.938~0.957),临界值(概率)为0.56,敏感度和特异性分别为86.0%和95.3%。PLS-DA模型对胃癌组和非胃癌组(胃部良性疾病+健康对照)的分类正确率分别为83.4%和81.8%。PLS-DA模型对Ⅰ~Ⅱ期和Ⅲ~Ⅳ期胃癌的分期诊断正确率分别为100.0%和82.9%。结论基于血清CA72-4、CA242、CA19-9的PLS-DA模型有助于胃癌的鉴别和分期诊断。
Objective To evaluate the diagnostic value of serum CA72-4,CA242,CA19-9and carcino-embryonic antigen(CEA)for gastric cancer.Methods Serum levels of CA72-4,CA242,CA19-9and CEA in 193 patients with gastric cancer,106 patients with benign gastric diseases and 86 healthy controls were measured by electrochemiluminescence assay,and all data was analyzed by the one-way analysis of variance,Logistic regression,receiver operating characteristic(ROC)curve and partial least square discrininant analysis(PLS-DA).Results The levels of serum CA242 and CEA in the stageⅠ-Ⅱgastric cancer group were significantly higher than those in the benign gastric diseases and healthy control group(P<0.05).The levels of serum CA72-4,CA242,CA19-9and CEA in the stageⅢ-Ⅳgastric cancer group were significantly higher than those in the stageⅠ-Ⅱgastric cancer group,benign gastric diseases and healthy control group(P<0.01).The area under the Logistic regression-ROC curve of the 4-marker combination was 0.956[95% confidence interval(95%CI):0.938-0.957],the cutoff value(probability)was 0.56,sensitivity and specificity were 86.0%and 95.3%respectively.The accuracies of PLS-DA model for the gastric cancer group and non-gastric cancer group(benign gastric diseases and healthy controls)were 83.4% and 81.8% respectively.The accuracies of PLS-DA model for stageⅠ-Ⅱ and Ⅲ-Ⅳ gastric cancer were 100.0% and 82.9% respectively.Conclusion The PLS-DA model based on serum CA72-4,CA242,CA19-9and CEA is helpful for the differentiation and the stage diagnosis of gastric cancer.
Objective To evaluate the diagnostic value of serum CA72-4,CA242,CA19-9and carcino-embryonic antigen(CEA)for gastric cancer.Methods Serum levels of CA72-4,CA242,CA19-9and CEA in 193 patients with gastric cancer,106 patients with benign gastric diseases and 86 healthy controls were measured by electrochemiluminescence assay,and all data was analyzed by the one-way analysis of variance,Logistic regression,receiver operating characteristic(ROC)curve and partial least square discrininant analysis(PLS-DA).Results The levels of serum CA242 and CEA in the stageⅠ-Ⅱgastric cancer group were significantly higher than those in the benign gastric diseases and healthy control group(P<0.05).The levels of serum CA72-4,CA242,CA19-9and CEA in the stageⅢ-Ⅳgastric cancer group were significantly higher than those in the stageⅠ-Ⅱgastric cancer group,benign gastric diseases and healthy control group(P<0.01).The area under the Logistic regression-ROC curve of the 4-marker combination was 0.956[95% confidence interval(95%CI):0.938-0.957],the cutoff value(probability)was 0.56,sensitivity and specificity were 86.0%and 95.3%respectively.The accuracies of PLS-DA model for the gastric cancer group and non-gastric cancer group(benign gastric diseases and healthy controls)were 83.4% and 81.8% respectively.The accuracies of PLS-DA model for stageⅠ-Ⅱ and Ⅲ-Ⅳ gastric cancer were 100.0% and 82.9% respectively.Conclusion The PLS-DA model based on serum CA72-4,CA242,CA19-9and CEA is helpful for the differentiation and the stage diagnosis of gastric cancer.
引文
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[4]Wang H,Zhang H,Deng P,et al.Tissue metabolic profiling of human gastric cancer assessed by(1)HNMR[J].BMC Cancer,2016,16(1):371-376.
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[6]廖峰,陈映霞,何泽明,等.糖类抗原CA72-4、CA19-9在胃癌诊断中的应用价值[J].放射免疫学杂志,2007,20(1):28-30.
[7]叶建峰,蔡小红,吴永友,等.多种肿瘤标志物在胃癌诊断中的价值[J].现代临床医学,2012,38(1):11-13.
[8]陈海燕.CA724、CEA、CA242、CA199肿瘤标志物联合检验在胃癌中的诊断价值[J].中国医药导报,2012,9(31):97-98.
[9]Molodianovitch K,Faraggi D,Reiser B.Comparing the areas under two correlated ROC curves:parametric and non-parametric approaches[J].Biochem J,2006,48(5):748-757.
[10]刘靳波,余晓林,夏乾峰,等.ROC曲线及Logistic回归评价肿瘤标志物在胃结肠肿瘤的诊断价值[J].第四军医大学学报,2008,29(14):1298-1300.
[11]田刚,周明术,杭永伦,等.肿瘤标志对肺癌诊断价值PLS-DA和ANN-MPL模型评估[J].中华肿瘤防治杂志,2014,21(5):380-383.
[2]甘建春,刘宁,王德,等.血清肿瘤标志物CEA、CA199及CA724在胃癌中的应用价值研究[J].中华全科医学,2014,12(6):882-884.
[3]林益振,蒋相霞,陈翔,等.D-D、CRP联合肿瘤标志物检测对胃癌早期诊断的价值[J].中国卫生检验杂志,2014,24(5):695-698.
[4]Wang H,Zhang H,Deng P,et al.Tissue metabolic profiling of human gastric cancer assessed by(1)HNMR[J].BMC Cancer,2016,16(1):371-376.
[5]粟文堂,舒玲玲,杨华喜,等.联合检测血清肿瘤标志物对胃癌的诊疗意义[J].检验医学与临床,2008,5(10):585-586.
[6]廖峰,陈映霞,何泽明,等.糖类抗原CA72-4、CA19-9在胃癌诊断中的应用价值[J].放射免疫学杂志,2007,20(1):28-30.
[7]叶建峰,蔡小红,吴永友,等.多种肿瘤标志物在胃癌诊断中的价值[J].现代临床医学,2012,38(1):11-13.
[8]陈海燕.CA724、CEA、CA242、CA199肿瘤标志物联合检验在胃癌中的诊断价值[J].中国医药导报,2012,9(31):97-98.
[9]Molodianovitch K,Faraggi D,Reiser B.Comparing the areas under two correlated ROC curves:parametric and non-parametric approaches[J].Biochem J,2006,48(5):748-757.
[10]刘靳波,余晓林,夏乾峰,等.ROC曲线及Logistic回归评价肿瘤标志物在胃结肠肿瘤的诊断价值[J].第四军医大学学报,2008,29(14):1298-1300.
[11]田刚,周明术,杭永伦,等.肿瘤标志对肺癌诊断价值PLS-DA和ANN-MPL模型评估[J].中华肿瘤防治杂志,2014,21(5):380-383.