应用决策树卡方自动交互检验法建立血清细胞角蛋白19片段对非小细胞肺癌的辅助诊断模型

Application of exhaustive CHAID method in establishing the diagnosis model of CYFRA19 in non-small cell lung cancer

目的采用CHAID法建立CYFRA21-1在非小细胞肺癌(NSCLC)中的辅助诊断模型。方法选取2013年1月-2014年12月来浙江省台州医院就诊的NSCLC初诊患者504例为NSCLC组,肺部良性疾病患者297例为良性对照组,测定血清CYFRA21-1、CEA、CA125及SCC含量,采用CHAID法确定其在辅助诊断NSCLC上的价值。收集2015年1月-2016年12月CYFRA21-1高于本文得出的诊断值的肺部相关疾病患者,计算其中的NSCLC患者比例来验证决策树CHAID法结果。结果 NSCLC组的4种肿瘤标志物均高于良性对照组,差异有统计学意义(P<0.05)。入选人群针对4种肿瘤标志物的决策树CHAID法自动分层,决策树按照CYFRA21-1分层,当CYFRA21-1高于10.8 ng/ml时,NSCLC患者的比例达100%,CYFRA21-1在5.6 ng/ml^10.8 ng/ml时,NSCLC患者的比例达93.8%。173例CYFRA21-1高于5.6 ng/ml的肺部相关疾病患者中,16例为良性疾病,157例为NSCLC,占90.8%;而CYFRA21-1高于10.8 ng/ml的肺部相关疾病患者共66例,均为NSCLC患者。结论 CYFRA21-1对于NSCLC患者具有较好的辅助诊断价值。

Objective To establish the diagnosis model of CYFRA21-1 by using exhaustive CHAID method in nonsmall-cell lung cancer（ NSCLC）. Methods The serum levels of CYFRA21-1,CEA,CA125 and SCC were detected in 504 patients with nonsmall-cell lung cancer（ NSCLC group）,297 patients with benign lung diseases（ benign group） in Taizhou Hospital of Zhejiang during January 2013-December 2014. Then its value was constructed by using exhaustive CHAID method. The lung related cases with higher diagnostic value of CYFRA21-1 than the results in this paper were collected to verify the value of strategic tree CHAID method by calculating the the proportion of NSCLC from January 2015 to May 2015. Results The 4 tumor markers in NSCLC group were significantly higher than that in the benign group,with the differences statistically significant（ P〈0. 05）. The enrolled cases were conducted for layer classification according to exhaustive CHAID decision tree analysis on 4tumor indicators,which suggested that when CYFRA21-1 was higher than 10. 8 ng/ml,the NSCLC patients accounted for100%,when CYFRA21-1 was within 5. 6 ng/ml-10. 8 ng/ml,the NSCLC patients accounted for 93. 8%. In 173 cases with lung related diseases and CYFRA21-1 higher than 5. 6 ng/ml,16 cases were eventually confirmed as benign and 157 cases were NSCLC（ 90. 8%）. The 66 cases with lung related diseases and CYFRA21-1 higher than 10. 8 ng/ml were all confirmed as NSCLC. Conclusion The serum CYFRA21-1 is a good tumor marker for the diagnosis of the NSCLC.