应用ROC曲线评价血清FSH、LH及T在非嵌合型克氏综合征诊断中的价值

Evaluation of the diagnostic value of the serum levels of FSH LH and T for nonmosaic klinefelter syndrome by using ROC Curve

目的探讨血清性激素FSH、LH和T在辅助诊断非嵌合型克氏综合征的临床价值。方法选取2014年1月至2016年7月于西北妇女儿童医院男性不育门诊就诊的非嵌合型克氏综合征患者123例作为观察组,同期染色体核型正常的男性不育患者127例作为对照组,对两组的血清促卵泡生成素(FSH)、黄体生成素(LH)及睾酮(T)进行比较分析。采用电化学发光法测定血清FSH、LH和T水平。应用受试者工作特征(ROC)曲线评价各指标的诊断效能,确定最佳诊断临界点,并对各指标诊断价值进行比较分析。结果观察组与对照组相比,血清FSH及LH水平较高,T水平较低,两组激素水平差异有统计学意义(P<0.05)。血清FSH、LH及T诊断非嵌合型克氏综合征时AUC分别为0.961、0.978及0.864,均大于0.5,两两比较均有统计学意义(P<0.05);血清FSH、LH及T诊断非嵌合型克氏综合征的cut off值分别为19.00m IU/m L、11.02m IU/m L及288.5 ng/dl,其对应的诊断敏感度分别为0.967、0.951、0.789,特异性分别为0.898、0.953、0.843。结论血清FSH、LH及T水平的测定,对非嵌合型克氏综合征均有较好的诊断价值,可以作为非嵌合型克氏综合征的初步筛查指标。

Objective：To study the clinical value of the serum levels of follicle stimulating hormone（FSH）,luteinizing hormone（LH）,and testosterone（T）in the diagnosis of nonmosaic Klinefelter syndrome. Methods：All cases were studied by retrospective analysis from Jan. 2014 to Jul. 2016 in Center of Assisted Reproductive Technology,Northwest Women′s and Children′s Hospital.123 patients with nonmosaic klinefelter syndrome were included as the experimental group,and 127 cases of males with normal karyotype and infertility as control group.The follicle stimulating hormone（FSH）,luteinizing hormone（LH）,and testosterone（T）levels in serum were detected with electrochemiluminescence. To evaluated the diagnostic performance,determine the optimal cutoff points and compare the diagnostic value of each parameter by using receiver operating characteristic curve.Results：Levels of FSH and LH in the serum of experimental group were significantly higher than those of the control group,but the T level was significantly lower than that of the control group（P〈0.05）. The areas under ROC（AUC）of FSH,LH and T were 0.961（〉0.5）,0.978（〉0.5）and 0.136（〉0.5）respectively and there were statistically difference between the three parameter s. The optimal cutoff point of FSH LH and T were 19.56 m IU/m L,11.06 m IU/Ml and 288.5 ng/dl respectively. The sesitivity of FSH LH and T were 0.967,0.951 and 0.789 respectively.The specificity of FSH LH and T were 0.898,0.953 and 0.843 respectively.Conclusion：The serum levels of FSH LH and T were valuable in the diagnosis of nonmosaic Klinefelter syndrome respectively and each of them may be utilized as preliminary indicators for nonmosaic Klinefelter syndrome screening.