肺鳞癌患者血清CYFRA21-1和SCC检测及ROC曲线和截断点的理论分析

目的:探讨血清细胞角蛋白19片段(CYFRA21-1)抗原和鳞癌抗原(SCC)对肺鳞癌的临床意义.方法:将研究对象分组,试验组为102例肺鳞癌患者,对照组为53例良性肺病患者.分别采用电化学发光法和酶联免疫法检测血清CYFRA21-1及SCC,测定值用t检验,率比较用x2检验.接受者工作特征(ROC)曲线及截断点选择理论评估CYFRA21-1及SCC的临床价值.结果:肺鳞癌组与良性肺病组CYFRA21-1和SCC水平差异有统计学意义；CYFRA21-1以3.3 ng/mL、SCC以1.5 ng/mL为诊断临界点,CYFRA21-1诊断肺鳞癌敏感性为57.84％,特异性为92.45％,准确性为69.68％,ROC曲线下面积为0.788;SCC诊断肺鳞癌敏感性为33.33％,特异性为92.45％,准确性为53.55％,ROC曲线下面积为0.691；CYFRA21-1诊断肺鳞癌最佳截断点为2.485或2.365 ng/mL,对应敏感性和特异性分别为65.7％、92.5％和67.6％、90.6％;SCC诊断肺鳞癌最佳截断点为0.55 ng/mL,对应敏感性和特异性分别为72.5％和62.3％.随肺鳞癌分期增高,CYFRA21-1和SCC浓度增高差异有统计学意义,CYFRA21-1敏感性增高差异有统计学意义,SCC敏感性无明显变化.结论:CYFRA21-1对肺鳞癌的诊断具有较高的临床价值,而SCC对肺鳞癌的诊断价值较低.

Clinical significance in squamous cell lung cancer patients with serum CYFRA21-1 and SCC by ROC curve and cut-off theory

OBJECTIVE: To make further efforts and investigate the clinical significance of cytokeratin fragment 19(CYFRA21-1)and squamous cell carcinoma antigen(SCC) of serum tumor markers(TM) in the diagnosis of squamous cell lung cancer patients.METHODS: The subjects were divided into two groups: the squamous cell lung cancer group(102 patients) and the benign lung disease group(53 patients).The electric chemisty irradiance was used to examine blood serum CYFRA21-1 and SCC was examined by ELISA.The results were examined by t-test,and the rate comparison were examined by Chi-square test.Receiver operator characteristic curve and cut-off choice theory were used to value the results.RESULTS: Significant difference of CYFRA21-1 and SCC levels was detected between the squamous cell lung cancer group and the benign lung disease group;At the threshold of 3.3 ng/mL of CYFRA21-1 and 1.5 ng/mL of SCC,sensitivity,specificity and accuracity : CYFRA21-1 were 57.84%,92.45% and 69.68% respectively in the squamous cell lung cancer group,ROC curve showed that the under-curve area of CYFRA21-1 was 0.788;SCC were 33.33%,92.45% and 53.55% respectively in the squamous cell lung cancer group,ROC curve showed that the under-curve area of SCC was 0.691;The optimal cut-off of CYFRA21-1 to diagnosis the squamous cell lung cancer were 2.485 or 2.365 ng/mL, sensitivity and specificity of CYFRA21-1 were 65.7%,92.5% and 67.6%,90.6% respectively.The optimal cut-off of SCC to diagnosis the squamous cell lung cancer were 0.55 ng/mL,sensitivity and specificity of SCC were 72.5% and 62.3%.As squamous cell lung cancer stages increasing,concentrations of CYFRA21-1 and SCC were higher significantly in advanced than early stages,sensitivity of CYFRA21-1 was higher significantly in advanced than early stages,but sensitivity of SCC was not.CONCLUSION: The serum CYFRA21-1 is a sensitive tumor marker higher value than SCC for the diagnosis of the squamous cell lung cancer.