ROC曲线评价血清IGF-1在胶质瘤中的诊断价值

Evaluation of diagnostic value of IGF-1 in glioma by ROC analysis

目的运用ROC曲线评价胰岛素样生长因子(IGF-1)在诊断胶质瘤中的应用价值。方法选取胶质瘤、非胶质来源肿瘤及健康对照组各40例。采用ELISA法对3组患者血清中的IGF-1进行定量检测,比较3组结果间的差异,评估胶质瘤的诊断临界值。结果非胶质来源肿瘤组血清IGF-1水平(37.77±46.29)μg/L和健康对照组(26.98±27.63)μg/L比较差异无统计学意义(P>0.05)。胶质瘤组血清IGF-1水平(643.13±792.19)μg/L显著高于非胶质来源肿瘤组和健康对照组(63.52±101.53)μg/L(P<0.01)。对实验数据进行ROC曲线分析显示,IGF-1诊断胶质瘤的ROC曲线下面积(AUC)为0.831(95%CI0.745～0.917),诊断临界值为110.425μg/L,其诊断敏感度为90.0%,诊断特异度为92.3%,阳性预期值为87.5%,阴性预期值为92.3%,正确率为90.5%,Youden值为82.3%。结论 IGF-1在诊断胶质瘤中具有较高的敏感度和特异度,可作为胶质瘤诊断指标之一。但由于IGF-1的局限性,寻求另一种或多种胶质瘤相关的血清标记物与IGF-1联合检测更具有意义。

Objective To evaluate the diagnostic value of insulin-like growth factor-1（IGF-1）in glioma by ROC analysis.Methods 40 patients with glioma and 40 patients with non-glial originatied tumor were entered into the study as experimental groups,and 40 healthy volunteers served as control.IGF-1 was detected by ELISA and its results of three groups were compared.The diagnostic critical value of glioma was evaluated.Results There was no difference between non-glial originatied tumor group（37.77±46.29）μg/L and control group（26.98±27.63）μg/L（P〉0.05）.The IGF-1 in glioma group（643.13±792.19）μg/L was higher than that in non-glial originatied tumor group combined with control group（63.52±101.53）μg/L（P〈0.01）.ROC curve analysis showed that the area under curve was 0.831（95%CI 0.745-0.917）,the diagnostic critical value was 110.425 μg/L,the sensitivity,specificity,predicted value of positive,predicted value of negative,correct rate and Youden′s index were 90.0%,92.3%,87.5%,92.3%,90.5% and 82.3%,respectively.Conclusion IGF-1 may be regarded as a diagnostic index of glioma for its high sensitivity and specificity.