利用 ROC 曲线评价 CEA、CA153在 HER -2阳性乳腺癌术后随访中的价值

Evaluating the value of CEA and CA153 during follow-up in HER-2 overexpressing breast cancer u-sing ROC curves

目的：用ROC曲线评价CEA及CA153监测HER-2阳性乳腺癌患者术后复发转移的价值，并确立诊断HER-2阳性乳腺癌患者术后复发转移的最佳临界值。方法收集127例HER-2阳性乳腺癌患者CEA及CA153数值，将其分为复发转移及未复发转移两组。绘制ROC曲线，找到最佳临界值，同时比较最佳临界值与常规诊断值诊断复发转移的优劣。结果复发转移组较未复发转移组CEA及CA153水平显著偏高（P＜0．0001），CEA、CA153诊断复发转移ROC曲线下面积分别为0．752、0．820，对应的最佳临界值分别为3．5 ng/mL、17．89 U/mL。 CEA和CA153最佳临界值敏感性分别为46．15％、65．38％，CEA和CA153最佳临界值特异性分别为97．33％、89．33％。结论 CEA、CA153在HER-2阳性乳腺癌患者术后判断复发转移中具有中等价值，诊断术后复发转移的最佳临界值分别为3．5 ng/mL、17．89 U/mL。

Objective To explore the value of carcinoembryonic antigen （ CEA） and cancer antigen 153 （ CA153 ） in detecting tumor recurrences and to establish the optimal operating point of diagnosis of recurrences in HER-2 overexpressing breast cancer using ROC curves .Methods A total of 127 HER -2 overexpressing breast cancer patients was enrolled into this study and subdivided into two groups ,the recurrence group and the non-recurrence group .We created a ROC curve and found out the optimal operating point .Then we compared the advantage of detecting recurrences between optimal operating point in the ROC curve and the diagnostic point that we usually used .Results The recurrence groups showed significantly higher CEA and CA 153 levels than the non-recurrence groups（P＆lt;0.0001）.The area under the curve（AUC）of the CEA and CA153 were 0.752 and 0.820 respectively and the optimal operating point were 3.5 ng/mL and 17.89 U/mL,respectively.The sensitivi-ties of the optimal operating point of CEA and CA 153 were 46.15%and 65.38%respectively,and the specifici-ties were 97.33%and 89.33%, respectively.Conclusion CEA and CA153 process medium value for detecting recurrences in HER-2 overexpressing breast cancer .