鳞状细胞癌抗原检测对子宫颈鳞癌的诊断价值和最佳临界值分析

Analysis of diagnostic value and optimal cut-off value of squamouse cell carcinoma antigen in diagnosis of cervical squamous cell carcinoma

目的分析鳞状细胞癌抗原(SCC-Ag)对子宫颈鳞癌的诊断价值,探讨应用受试者操作特征曲线(ROC)诊断子宫颈鳞癌的最佳临界值。方法研究纳入134例子宫颈鳞癌患者和134名健康妇女,采用化学发光免疫夹心法检测血清中SCC-Ag水平。应用SPSS 11.5软件绘制ROC曲线,分析诊断效能。结果与正常对照组相比,子宫颈鳞癌组的SCC-Ag水平明显升高(P<0.01)。ROC曲线下面积为0.908。SCC-Ag诊断子宫颈鳞癌的最佳临界值为1.798 ng/ml,灵敏度为75.4%,特异度为96.3%;使用仪器说明书推荐的临界值(2.5 ng/ml)诊断子宫颈鳞癌组,灵敏度为65.7%,特异度为97.8%。结论 SCC-Ag对于子宫颈鳞癌具有诊断价值。使用ROC确定的最佳临界值,尽管特异度略有下降,但灵敏度明显提高,将更有利于子宫颈鳞癌的辅助诊断。

Objective To analyze the diagnostic value of squamouse cell carcinoma antigen （SCC-Ag）and the optimal cut-off value of ROC curve in the diagnosis of cervical squamous cell carcinoma.Methods A total of 134 patients with cervical squamous cell carcinoma and 134 healthy women were enrolled in this study.The levels of serum SCC-Ag were detected by sandwich chemiluminescence immunoassay.ROC curve was obtained using SPSS 11.5 software to analyze the diagnostic efficacy.Results Compared with the normal controls,the SCC-Ag levels in patients with cervical squamous cell carcinoma were significantly increased （P〈0.01）.The area under the ROC curve was 0.908.The optimal cut-off value of SCC-Ag for diagnosis of cer-vical squamous cell carcinoma was 1.798 ng/ml with a sensitivity of 75.4% and specificity of 96.3%.If using the cut-off value of 2.5 ng/ml recommended by the manufacturer＆#39;s instructions,the sensitivity was 65.7% and the specificity was 97.8%.Conclusions SCC-Ag has diagnostic value for of cervical squamous cell carcino-ma.The optimal cut-off value determined by the ROC curve could be conducive to the diagnosis of cervical squamous cell carcinoma because it improves the sensitivity significantly while decreases the specificity slightly.