ROC曲线评价NLR、PLR、CEA、NSE对肺癌的诊断价值

Application of ROC curve in the analysis and evaluation of the diagnostic value of NLR,PLR,CEA and NSE in lung cancer

目的探讨中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、癌胚抗原(CEA)和神经元特异性烯醇化酶(NSE)在肺癌的诊断价值。方法对186例肺癌患者及114例健康体检者进行血常规及血清CEA和NSE检测,并利用ROC曲线分析NLR、PLR、CEA、NSE单独和联合检测的诊断效能,并找出其cutoff值。结果 1.肺癌组全血NLR、PLR及血清CEA、NSE水平均高于健康对照组,差异有统计学意义(P<0.05)。2.NLR、PLR、CEA和NSE的ROC曲线下面积(AUC)分别为0.867、0.802、0.889和0.842,诊断临界点分别为2.61、123.19、2.54μg/L和12.54μg/L,灵敏度分别为72.04%、65.59%、70.97%和72.04%,特异性分别为96.49%、89.46%、94.47%和84.21%,诊断指数分别为168.53%、155.06%、165.44%和156.25%。3.CEA+NLR、CEA+PLR、CEA+NSE和CEA+NLR+PLR+NSE四种组合的灵敏度分别为89.25%、90.32%、89.25%和95.70%,特异性分别为94.74%、91.23%、78.95%和68.42%,诊断指数分别为183.99%、181.55%、168.20%和164.12%。结论 NLR、PLR、CEA和NSE不宜单独用于肺癌的诊断,需联合使用。

Objective To investigate the diagnosis value of neutrophil to lymphocyte ratio（NLR）,platelet to lymphocyte ratio（PLR）,carcinoembryonic antiG-en（CEA）and neuron-specific enolase（NSE）in lung cancer.Methods The whole blood routine and serum concentration of CEA and NSE were measured in 186 patients with lung cancer and 114 healthy subjects.Used ROC curve to analysis the diagnostic efficacy of NLR,PLR,CEA,NSE alone and in combination,and discovered their cutoff point.Results 1.The whole blood routine and serum concentration of CEA and NSE in lung cancer were significantly higher than those in control（P〈0.05）.2.The areas under ROC curve（AUC）of NLR,PLR、CEA and NSE were 0.867,0.802,0.889 and 0.842 respectively,the clinical diagnostic critical points were 2.61,123.19,2.54μg/L and 12.54μg/L respectively,the sensibilities were 72.04%,65.59%,70.97% and 72.04%,the specificities were 96.49%,89.46%,94.47% and 84.21%,the diagnosis indexes were 168.53%,155.06%,165.44%and 156.25%.3.The sensibilities of CEA combined with NLR,CEA combined with PLR,CEA combined with NSE,CEA combined with NLR,PLR and NSE were 89.25%,90.32%,89.25% and 95.70% respectively,the specificities were 94.74%,91.23%,78.95% and 68.42% respectively,the diagnosis indexes were 183.99%,181.55%,168.20%and 164.12%respectively.Conclusion NLR,PLR,CEA and NSE should not be alone for the diagnosis of lung cancer,but need combination.