血清CA72-4、CA242、CA19-9和CEA的PLS-DA模型对胃癌的诊断价值

Diagnostic value of PLS-DA model of serum CA72-4,CA242,CA19-9 and CEA for gastric cancer

目的探讨联合检测血清CA72-4、CA242、CA19-9和癌胚抗原(CEA)对胃癌的诊断价值。方法采用电化学发光法测定193例胃癌患者、106例胃良性疾病患者和86例健康对照者血清CA72-4、CA242、CA19-9和CEA水平,进行单因素方差分析、Logistic回归-ROC曲线和偏最小二乘-判别分析(PLS-DA)。结果Ⅰ~Ⅱ期胃癌组患者血清CA242和CEA水平显著高于良性疾病组和健康对照组(P<0.05)。胃癌组Ⅲ~Ⅳ期患者血清CA72-4、CA242、CA19-9和CEA水平显著高于Ⅰ~Ⅱ期、良性疾病组和健康对照组(P<0.01)。4种标志物联合的Logistic回归-ROC曲线下面积为0.956(95%置信区间:0.938~0.957),临界值(概率)为0.56,敏感度和特异性分别为86.0%和95.3%。PLS-DA模型对胃癌组和非胃癌组(胃部良性疾病+健康对照)的分类正确率分别为83.4%和81.8%。PLS-DA模型对Ⅰ~Ⅱ期和Ⅲ~Ⅳ期胃癌的分期诊断正确率分别为100.0%和82.9%。结论基于血清CA72-4、CA242、CA19-9的PLS-DA模型有助于胃癌的鉴别和分期诊断。

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