Logistic回归及ROC曲线综合评价CA15-3、CA125、CK19、CEA、AFP和CA199在乳腺癌术后监测中的应用价值

Comprehensive evaluation of the diagnostic value of CA15-3,CA125,CK19,CEA,AFP and CA199 for breast cancer's postoperative monitoring by ROC curve and logistic regression

目的:应用Logistic回归模型及受试者工作特征曲线(Receiver operating characteristic curve,ROC曲线)探讨多种血清肿瘤标志物在乳腺癌术后监测中的应用价值。方法:采用化学发光免疫分析法测定34例术后复发转移患者及76例无复发患者的血清CA15-3、CA125、CK19、CEA、AFP、CA199水平,通过组间均值比较和Logistic逐步回归分析筛选出有效指标,并通过ROC曲线评价其在术后复发转移判断中的诊断价值。结果:其中3项血清肿瘤标志物CA15-3、CK19和CEA入选Logistic回归方程,对应的曲线下面积分别为0.974、0.922、0.913,阳性检出率分别为82.4%、73.5%和64.7%。结论:肿瘤标志物CA15-3、CK19、CEA在术后复发或转移诊断中有较高的应用价值,可作为乳腺癌术后监测复发转移的有效指标。

Objective：To explore the diagnostic value of a variety of serum tumor markers for breast cancer recurrence and metastasis after operation by receiver operating characteristic curve（ROC curve） and logistic regression.Methods：Serum CA15-3,CA125,CK19,CEA,AFP,CA199 levels were measured by electronic chemiluminescent immunoassay（ECILA） technique in 34 cases of postoperative recurrence and metastasis and in 76 cases without recurrence,screening multiple diagnostic parameters for breast cancer＇s postoperative monitoring through the mean comparison between the two groups and logistic stepwise regression analysis,to evaluate the diagnostic value of them in postoperative recurrence and metastasis through ROC curves.Results：Three of serum tumor markers CA15-3,CK19 and CEA were selected into Logistic regression equation.The corresponding areas under the curve were 0.974,0.922,0.913 respectively;the positive detection rates were 82.4%（28/34）,73.5%（25/34） and 64.7%（22/34） respectively.Conclusion：CA15-3,CK19 and CEA have a higher value in the diagnosis of postoperative recurrence or metastasis;therefore it can be used as an effective indicator for monitoring recurrence after operation.