中国健康成年男性癌胚抗原参考值的地理分布规律
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摘要
为探讨中国健康成年男性肿瘤标志物癌胚抗原(Carcino-embryonic antigen,CEA)参考值与地理因素的关系,搜集了中国208个单位测定的30 196例健康成年男性癌胚抗原参考值数据,通过相关分析从12项地理指标中筛选出4项因素,并采用岭回归分析方法构建预测模型,运用地统计分析方法得出中国健康成年男性肿瘤标志物癌胚抗原参考值的空间分布图.结果表明,中国健康成年男性癌胚抗原参考值的最优预测模型回归方程为=1.83+0.0033 X_1-0.00018 X_3+0.00726 X_5+0.00003 X_7±0.63.通过分布图可以直观地看出,我国健康成年男性癌胚抗原参考值呈现出东部高、西部低的空间分布趋势.中国地域辽阔,内部差异性大,在实际中为了制定不同地域成年男性癌胚抗原参考值标准,提高临床诊断的准确性,应充分考虑地域性差异.
In order to explore the CEA reference value and geographical factors' relationship of healthy adults,the CEA reference values of 30 196 healthy male adults measured by 208 units in China are collected.Through correlation analysis,4factors are selected from 12 geographical indexes,and the prediction model is constructed by ridge regression analysis.The spatial distribution map of CEA reference value is obtained by geostatistical analysis.The results show that the regression equation of the reference value for CEA is as follows:=1.83+0.0033 X_1-0.00018 X_3 +0.00726 X_5 +0.00003 X_7 ±0.63.Through the distribution map,it is intuitively found that the spatial distribution trend of CEA reference value is high in the east and low in the west.China has a vast territory and great internal differences,in order to establish the reference standard of CEA in different regions and improve the accuracy of clinical diagnosis,regional differences should be fully considered.
In order to explore the CEA reference value and geographical factors' relationship of healthy adults,the CEA reference values of 30 196 healthy male adults measured by 208 units in China are collected.Through correlation analysis,4factors are selected from 12 geographical indexes,and the prediction model is constructed by ridge regression analysis.The spatial distribution map of CEA reference value is obtained by geostatistical analysis.The results show that the regression equation of the reference value for CEA is as follows:=1.83+0.0033 X_1-0.00018 X_3 +0.00726 X_5 +0.00003 X_7 ±0.63.Through the distribution map,it is intuitively found that the spatial distribution trend of CEA reference value is high in the east and low in the west.China has a vast territory and great internal differences,in order to establish the reference standard of CEA in different regions and improve the accuracy of clinical diagnosis,regional differences should be fully considered.
引文
[1]陈静静,陈建民,孙泉.肿瘤标志物CEA、CK19、SCC检测在肺癌患者诊断中的临床价值[J].现代免疫学,2017,37(3):22.
[2]梁子坤,吴恩东,孙勇,等.肿瘤标志物NSE和Cyfra21-1在肺癌化疗效果评估中的价值[J].中国医药导报,2014,11(20):55.
[3]XIE Y,TODD N W,LIU Z Q,et al.Altered miRNA exepression in sputum for diagnosis of nonsmall cell lung cancer[J].Lung Cancer,2010,67(2):170.
[4]徐恩赐,王利利,周菊英,等.联合检测血清CEA、CYFRA21-1、NSE在肺癌诊断、分期、分型中的意义[J].中国血液流变学杂志,2012,22(2):270.
[5]张英平,潘春荣,卢锦沛.血清肿瘤标志物AFP、CEA联合检测对原发性肝癌的诊断及预后评估价值分析[J].中国医药科学,2017,7(21):140.
[6]任羽,贺爱军.血清肿瘤标志物联合骨髓形态检测在淋巴瘤患者中的临床意义[J].中国肿瘤临床与康复,2017,24(7):803.
[7]沙培培.血清CEA、CA199与CA242联合检测在诊断胰腺癌中的意义[J].当代医药论丛,2017,15(12):113.
[8]胡云辉,赵春樱,王若峥.肺癌相关肿瘤标记物的临床应用[J].新疆医科大学学报,2013,36(1):16.
[9]刘军.四种肿瘤标志物测定对肝癌的诊断价值[J].中国肿瘤临床与康复,2017,24(1):30.
[10]刘蕾,赵鹏,邢雪梅,等.乙型肝炎后肝硬化患者血清AFP-L3、GP-73、CEA与HBV-DNA载量的关系及在肝硬化分级诊断中的价值[J].检验医学与临床,2018,15(3):320.
[11]陈一超,辇伟奇,冉静,等.肿瘤标志物联合检测对肺癌诊断、病理分型和临床分期的临床价值[J].国际检验医学杂志,2018,39(1):32.
[12]黄英,简友丽,陈红.影像学联合CA19-9、CA125、CEA诊断及鉴别诊断胰腺癌的价值研究[J].海南医学院学报,2018,24(2):266.
[13]谢而付,蒋理,凌芸,等.血清CEA、CA19-9和CHI3L1在胰腺癌患者中的诊断价值比较[J].实用医学杂志,2018,34(2):309.
[14]陆志斌,熊磊,丛壮壮,等.早期食管癌患者外周血DKK-1、CEA、CYFRA21-1和NSE的检测及临床意义[J].现代肿瘤医学,2017,25(15):2415.
[15]PORCEL J M,CIVIT C,ESQUERDA A,et al.Utilidad de la medici o'n de CEA y CA 15-3en los exudados pleurales no purulentos para diagnosticar malignidad:experiencia de un u'nico centro[J].Archivos de Bronconeumología,2017,53(8):427.
[16]XU H X,LIU L,XIANG J F,et al.Postoperative serum CEA and CA125levels are supplementary to perioperative CA19-9levels in predicting operative outcomes of pancreatic ductal adenocarcinoma[J].Surgery,2017,161(2):373.
[17]TOZZOLI R,BASSO S M,D'AURIZIO F,et al.Evaluation of predictive value of pleural CEA in patients with pleural effusions and histological findings:A prospective study and literature review[J].Clinical Biochemistry,2016,49(16/17):1227.
[18]TRUTA L A A N A,MOREIRA F T C,SALES MG F.A dye-sensitized solar cell acting as the electrical reading box of an immunosensor:application to CEA determination[J].Biosensors&Bioelectronics,2018,107(7):94.
[19]尚守亮.健康人群癌胚抗原轻度升高原因分析[J].检验医学与临床,2011,8(18):2269.
[20]董佳,刘安娜,王厚照.吸烟对男性血清癌胚抗原含量的影响[J].检验医学与临床,2010,7(24):2760.
[21]丁珂,滕毅.血清CEA、NSE与CYFRA21-1联合检测在肺癌诊断及疗效评估中的价值[J].贵州医科大学学报,2017,42(7):803.
[22]洪军,孙爱军.血清CEA、CA125、CYFRA21-1、NSE联合检测在肺癌诊断中的应用价值[J].河北医药,2014,36(5):697.
[23]陈岩松,陈燕,陈娜娟.结直肠癌患者血清白细胞介素6水平及与肿瘤疗效关系[J].标记免疫分析与临床,2017,24(11):1274.
[24]SMIT M,BUDDINGH K T,BOSMA B,et al.Abdominal compartment syndrome and intraabdominal ischemia in patients with severe acute pancreatitis[J].World Journal of Surgery,2016,40(6):1454.
[25]SCHULTZ N A,CHRISTENSEN I J,WERNERJ,et al.Diagnostic and prognostic impact of circulating YKL_40,IL_6,and CA 19.9in patients with pancreatic cancer[J].PLoS One,2013,8(6):e67059.
[26]GETIS A,ORD J K.The analysis of spatial association by use of distance statistics[J].Geographical Analysis,2010,24(3):189.
[27]TOBLER W R.A computer movie simulating urban growth in the Detroit region[J].Economic Geography,1970,46(suppl):234.
[28]王福彦,刘相辰,周玲玲,等.SPSS在医学统计中的应用[M].北京:知识产权出版社,2015.
[29]尹希果.计量经济学:原理与操作[M].重庆:重庆大学出版社,2009.
[30]MARQUARDT D W,SNEE R D.Ridge regression in practice[J].Am Statis,1975,29(1):3.
[31]张明鑫,葛淼.区域地理环境对中国男性青年收缩压参考值影响分析[J].地理科学,2012,32(11):1404.
[32]CRESSIE N A,SHEFFIELD L J,WHITFORD HJ.Use of the one sample t-test in the real world[J].J Chron Dis,1984,37(2):107.
[33]汤国安,杨昕.ArcGIS地理信息系统空间分析实验教程[M].北京:科学出版社,2009.
[34]陈胜可,刘荣.SPSS统计分析从入门到精通[M].第3版.北京:清华大学出版社,2015.
[35]孙浩林,彭慧,傅华.慢性病患者健康素养量表信效度的研究[J].复旦学报(医学版),2012,39(3):268.
[36]苏晓灵,周白丽,王嵘,等.高原不同海拔地区高脂血症患者血脂及血液流变学相关性研究[J].高原医学杂志,2009,19(4):8.
[37]崔建华,王引虎,郭玉新,等.高原移居者出现高原病症状时的血生化改变[J].中国临床康复,2006,10(36):14.
[38]SPLAVSKI B,VRANKOVIC D,SARIC G,et al.Early surgery and other indicators influencing the outcome of war missile skull base injuries[J].Surg Neuorol,1998,50(3):194.
[39]杨林生,王五一,谭见安,等.环境地理与人类健康研究成果与展望[J].地理研究,2010,29(9):1571.
[40]郑佐桓,鞠宝兆.《黄帝内经》治疗原则研究[J].辽宁中医药大学学报,2014,16(1):88.
[2]梁子坤,吴恩东,孙勇,等.肿瘤标志物NSE和Cyfra21-1在肺癌化疗效果评估中的价值[J].中国医药导报,2014,11(20):55.
[3]XIE Y,TODD N W,LIU Z Q,et al.Altered miRNA exepression in sputum for diagnosis of nonsmall cell lung cancer[J].Lung Cancer,2010,67(2):170.
[4]徐恩赐,王利利,周菊英,等.联合检测血清CEA、CYFRA21-1、NSE在肺癌诊断、分期、分型中的意义[J].中国血液流变学杂志,2012,22(2):270.
[5]张英平,潘春荣,卢锦沛.血清肿瘤标志物AFP、CEA联合检测对原发性肝癌的诊断及预后评估价值分析[J].中国医药科学,2017,7(21):140.
[6]任羽,贺爱军.血清肿瘤标志物联合骨髓形态检测在淋巴瘤患者中的临床意义[J].中国肿瘤临床与康复,2017,24(7):803.
[7]沙培培.血清CEA、CA199与CA242联合检测在诊断胰腺癌中的意义[J].当代医药论丛,2017,15(12):113.
[8]胡云辉,赵春樱,王若峥.肺癌相关肿瘤标记物的临床应用[J].新疆医科大学学报,2013,36(1):16.
[9]刘军.四种肿瘤标志物测定对肝癌的诊断价值[J].中国肿瘤临床与康复,2017,24(1):30.
[10]刘蕾,赵鹏,邢雪梅,等.乙型肝炎后肝硬化患者血清AFP-L3、GP-73、CEA与HBV-DNA载量的关系及在肝硬化分级诊断中的价值[J].检验医学与临床,2018,15(3):320.
[11]陈一超,辇伟奇,冉静,等.肿瘤标志物联合检测对肺癌诊断、病理分型和临床分期的临床价值[J].国际检验医学杂志,2018,39(1):32.
[12]黄英,简友丽,陈红.影像学联合CA19-9、CA125、CEA诊断及鉴别诊断胰腺癌的价值研究[J].海南医学院学报,2018,24(2):266.
[13]谢而付,蒋理,凌芸,等.血清CEA、CA19-9和CHI3L1在胰腺癌患者中的诊断价值比较[J].实用医学杂志,2018,34(2):309.
[14]陆志斌,熊磊,丛壮壮,等.早期食管癌患者外周血DKK-1、CEA、CYFRA21-1和NSE的检测及临床意义[J].现代肿瘤医学,2017,25(15):2415.
[15]PORCEL J M,CIVIT C,ESQUERDA A,et al.Utilidad de la medici o'n de CEA y CA 15-3en los exudados pleurales no purulentos para diagnosticar malignidad:experiencia de un u'nico centro[J].Archivos de Bronconeumología,2017,53(8):427.
[16]XU H X,LIU L,XIANG J F,et al.Postoperative serum CEA and CA125levels are supplementary to perioperative CA19-9levels in predicting operative outcomes of pancreatic ductal adenocarcinoma[J].Surgery,2017,161(2):373.
[17]TOZZOLI R,BASSO S M,D'AURIZIO F,et al.Evaluation of predictive value of pleural CEA in patients with pleural effusions and histological findings:A prospective study and literature review[J].Clinical Biochemistry,2016,49(16/17):1227.
[18]TRUTA L A A N A,MOREIRA F T C,SALES MG F.A dye-sensitized solar cell acting as the electrical reading box of an immunosensor:application to CEA determination[J].Biosensors&Bioelectronics,2018,107(7):94.
[19]尚守亮.健康人群癌胚抗原轻度升高原因分析[J].检验医学与临床,2011,8(18):2269.
[20]董佳,刘安娜,王厚照.吸烟对男性血清癌胚抗原含量的影响[J].检验医学与临床,2010,7(24):2760.
[21]丁珂,滕毅.血清CEA、NSE与CYFRA21-1联合检测在肺癌诊断及疗效评估中的价值[J].贵州医科大学学报,2017,42(7):803.
[22]洪军,孙爱军.血清CEA、CA125、CYFRA21-1、NSE联合检测在肺癌诊断中的应用价值[J].河北医药,2014,36(5):697.
[23]陈岩松,陈燕,陈娜娟.结直肠癌患者血清白细胞介素6水平及与肿瘤疗效关系[J].标记免疫分析与临床,2017,24(11):1274.
[24]SMIT M,BUDDINGH K T,BOSMA B,et al.Abdominal compartment syndrome and intraabdominal ischemia in patients with severe acute pancreatitis[J].World Journal of Surgery,2016,40(6):1454.
[25]SCHULTZ N A,CHRISTENSEN I J,WERNERJ,et al.Diagnostic and prognostic impact of circulating YKL_40,IL_6,and CA 19.9in patients with pancreatic cancer[J].PLoS One,2013,8(6):e67059.
[26]GETIS A,ORD J K.The analysis of spatial association by use of distance statistics[J].Geographical Analysis,2010,24(3):189.
[27]TOBLER W R.A computer movie simulating urban growth in the Detroit region[J].Economic Geography,1970,46(suppl):234.
[28]王福彦,刘相辰,周玲玲,等.SPSS在医学统计中的应用[M].北京:知识产权出版社,2015.
[29]尹希果.计量经济学:原理与操作[M].重庆:重庆大学出版社,2009.
[30]MARQUARDT D W,SNEE R D.Ridge regression in practice[J].Am Statis,1975,29(1):3.
[31]张明鑫,葛淼.区域地理环境对中国男性青年收缩压参考值影响分析[J].地理科学,2012,32(11):1404.
[32]CRESSIE N A,SHEFFIELD L J,WHITFORD HJ.Use of the one sample t-test in the real world[J].J Chron Dis,1984,37(2):107.
[33]汤国安,杨昕.ArcGIS地理信息系统空间分析实验教程[M].北京:科学出版社,2009.
[34]陈胜可,刘荣.SPSS统计分析从入门到精通[M].第3版.北京:清华大学出版社,2015.
[35]孙浩林,彭慧,傅华.慢性病患者健康素养量表信效度的研究[J].复旦学报(医学版),2012,39(3):268.
[36]苏晓灵,周白丽,王嵘,等.高原不同海拔地区高脂血症患者血脂及血液流变学相关性研究[J].高原医学杂志,2009,19(4):8.
[37]崔建华,王引虎,郭玉新,等.高原移居者出现高原病症状时的血生化改变[J].中国临床康复,2006,10(36):14.
[38]SPLAVSKI B,VRANKOVIC D,SARIC G,et al.Early surgery and other indicators influencing the outcome of war missile skull base injuries[J].Surg Neuorol,1998,50(3):194.
[39]杨林生,王五一,谭见安,等.环境地理与人类健康研究成果与展望[J].地理研究,2010,29(9):1571.
[40]郑佐桓,鞠宝兆.《黄帝内经》治疗原则研究[J].辽宁中医药大学学报,2014,16(1):88.