Logistic回归和PLS-DA模型评价肿瘤标志物对结肠癌的诊断价值

发布时间：2018-04-28 08:18

本文选题：结肠肿瘤 + 肿瘤M型丙酮酸激酶　；参考：《重庆医学》2017年08期

【摘要】：目的探讨血清肿瘤M2型丙酮酸激酶(TuM2-PK)、癌胚抗原(CEA)、糖类抗原CA199、CA724、CA125和CA242对结肠癌的诊断价值。方法采用酶联免疫吸附法(ELISA)和电化学发光法测定231例结肠癌、105例结肠良性病和166例健康对照血清TuM2-PK、CEA、CA199、CA724、CA125和CA242水平。采用ROC曲线和Logistic-ROC曲线比较单一和组合标志物的诊断效能,以最优组合标志物建立结肠癌Logistic回归和偏最小二乘判别分析(PLS-DA)诊断模型。结果结肠癌组血清TuM2-PK、CEA、CA199、CA125和CA242水平显著高于结肠良性病组和健康对照组(P0.05)。血清CA199诊断结肠癌的ROC曲线下面积(AUC)最高[0.79(95%CI:0.75~0.83)],在临界值为69.5U/L时灵敏度和特异性分别为64.1%和89.7%。Logistic-ROC曲线中各组合标志物较单一指标的AUC高,其中(CEA+CA199+TuM2-PK)的AUC较为理想[0.89(95%CI:0.86~0.92)]。血清(CEA+CA199+TuM2-PK)的Logistic回归和PLS-DA模型对结肠癌的诊断准确率分别为82.7%和77.5%,对非结肠癌的诊断准确率分别为93.7%和95.6%。结论联合检测血清CEA、CA199和TuM2-PK是较为理想的肿瘤标志物组合,有助于结肠癌的早期诊断。
[Abstract]:Objective to investigate the diagnostic value of serum type M2 pyruvate kinase TuM2-PKA, carcinoembryonic antigen (CEA), carbohydrate antigen CA724 (CA125) and CA242 in the diagnosis of colon cancer. Methods the serum levels of TuM2-PKCEA CA724 CA125 and CA242 were measured by Elisa and electrochemiluminescence in 105 patients with benign colon disease and 166 healthy controls. ROC curve and Logistic-ROC curve were used to compare the diagnostic efficacy of single and combined markers, and Logistic regression and partial least squares discriminant analysis were used to establish the diagnostic model of colon cancer by Logistic regression and partial least squares discriminant analysis. Results the levels of serum TuM2-PKACA199CA125 and CA242 in colon cancer group were significantly higher than those in benign colon disease group and healthy control group (P 0.05). The area under the ROC curve of serum CA199 for diagnosis of colon cancer was the highest [0.7995 CI: 0.750.803]. When the critical value was 69.5U/L, the sensitivity and specificity were 64.1%, respectively, and the combined markers in 89.7%.Logistic-ROC curve were higher than that of AUC with a single index. The AUC of 89.7%.Logistic-ROC CA199 TuM2-PKK was more ideal [0.8995 CI: 0.860.92]. The accuracy of Logistic regression and PLS-DA model for diagnosis of colon cancer were 82.7% and 77.5%, respectively, and the diagnostic accuracy for non-colon cancer were 93.7% and 95.6%, respectively. Conclusion combined detection of serum CEA CA199 and TuM2-PK is an ideal combination of tumor markers, which is helpful for early diagnosis of colon cancer.
【作者单位】：西南医科大学附属医院肝胆外科;西南医科大学附属医院检验科;四川省泸州市人民医院肝胆外科;
【基金】：四川省教育厅重点项目(2005A076) 四川省泸州市科技计划项目[2015-S-51(1/3)] 西南医科大学自然科学基金(30543) 西南医科大学附属医院人才基金资助项目(12277)
【分类号】：R735.35

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