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目的:探讨肺癌患者血清癌胚抗原(CEA)、鳞状细胞癌抗原(SCC-Ag)和铁蛋白(SF)经Logistic回归及ROC曲线综合分析的诊断价值。方法:采用电化学发光仪对受试者的CEA进行测定,采用酶联免疫吸附测定法对受试者的SCC-Ag进行测定,采用免疫比浊法对受试者的SF进行测定,并对其进行Logistic回归及ROC曲线综合分析。结果:与对照组相比,肺癌组3种肿瘤标志物CEA、SCC-Ag及SF水平均明显升高且差异具有统计学意义(P<0.01)。腺癌组患者CEA水平明显高于鳞癌组及小细胞癌组且差异具有统计学意义(P<0.01),鳞癌患者SCC-Ag水平明显高于腺癌和小细胞癌患者且差异具有统计学意义(P<0.01),而3种病理类型肺癌患者间SF水平差异无统计学意义(F=0.529,P>0.05)。与Ⅰ+Ⅱ分期相比,Ⅲ+Ⅳ分期3种肿瘤标志物CEA、SCC-Ag及SF明显升高且差异具有统计学意义(P<0.05或<0.01)。以对照组为参照,CEA、SCC-Ag、SF对肺癌的敏感性分别为46.5%、46.5%、70.0%,特异性分别为93.1%、96.6%、86.6%,而3项联合检测的敏感性为89.9%,特异性为75.9%。Logistic分析结果显示CEA、SCC-Ag及SF与肺癌具有相关性(P<0.01)。经统计分析可知,Y的ROC曲线的面积AUC明显大于3种肿瘤标志物CEA、SCC-Ag及SF任一指标的曲线下的面积AUC。结论:血清CEA、SCC-Ag和SF 3项指标对肺癌诊断意义重大,同时借助Logistic回归及ROC曲线分析有助于提高诊断的准确性。
Objective: To investigate the diagnostic value of serum carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC-Ag) and ferritin (SF) in patients with lung cancer by Logistic regression and ROC curve analysis. Methods: The CEA of the subjects was determined by electrochemiluminescence apparatus. The SCC-Ag of the subjects was determined by enzyme-linked immunosorbent assay (ELISA), and the SF of the subjects was measured by immunoturbidimetry. Logistic regression and ROC curve analysis. Results: Compared with the control group, the levels of CEA, SCC-Ag and SF in the three tumor markers of lung cancer group were significantly increased and the difference was statistically significant (P <0.01). The CEA level in adenocarcinoma group was significantly higher than that in squamous cell carcinoma and small cell carcinoma group (P <0.01). The SCC-Ag level in squamous cell carcinoma was significantly higher than that in adenocarcinoma and small cell carcinoma (P <0.01). There was no significant difference in SF level between the three pathological types of lung cancer patients (F = 0.529, P> 0.05). Compared with Ⅰ + Ⅱ stage, CEA, SCC-Ag and SF of three kinds of tumor markers in stage Ⅲ + Ⅳ were significantly increased (P <0.05 or <0.01). The sensitivity of CEA, SCC-Ag and SF to lung cancer were 46.5%, 46.5% and 70.0%, respectively, with specificity of 93.1%, 96.6% and 86.6% respectively, while the sensitivity of the three combined tests 89.9%, specificity 75.9%. Logistic analysis showed that CEA, SCC-Ag and SF were correlated with lung cancer (P <0.01). The statistical analysis shows that the area AUC of the ROC curve of Y is obviously larger than the area AUC under the curve of any one of the three tumor markers CEA, SCC-Ag and SF. Conclusion: Serum CEA, SCC-Ag and SF 3 indicators of lung cancer diagnosis of great significance, at the same time by means of Logistic regression and ROC curve analysis will help to improve the diagnostic accuracy.