Zhu Xian, Zhou Wei, Chen Yan, Gao Jun, Kong Fanyang, Liu Jie, Li Zhaoshen, Gao Jun, Bai Yu
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, China,
Tumour Biol. 2014 Jun;35(6):5129-35. doi: 10.1007/s13277-014-1625-6. Epub 2014 Mar 27.
This study aims to evaluate the diagnostic accuracy of carbohydrate antigen 125 (CA125) in male patients for predicting gastrointestinal malignant diseases. One hundred twenty consecutive male patients underwent CA125 test after admission to the Department of Gastroenterology in Changhai Hospital, the Second Military Medical University, from April to June 2013. Data of age, main symptoms, and final diagnosis were summarized. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of CA125 for malignancy were estimated, and the receiver operating characteristic (ROC) analysis and the area under the curve (AUC) were also performed to evaluate the diagnostic value of CA125 in male patients. The PPV, NPV, PLR, and NLR of CA125 in malignancy were 55 %, 69 %, 1.90, and 0.71, respectively. However, we found that an elevated serum CA125 level was more common in male patients with serous effusion than those with malignancy. The PPV, NPV, PLR, and NLR of CA125 in serous effusion were 85 %, 96 %, 12.70, and 0.09, respectively. In the ROC analysis, the AUC values for CA125 was 0.96 (95 % confidence interval, 0.93-0.99) for discriminating patients with serous cavity effusion from those without serous effusion. CA125 has a higher accuracy in detecting serous effusion than malignancy in male patients with gastrointestinal diseases. It is of little significance for male patients to perform CA125 test for malignancy.
本研究旨在评估糖类抗原125（CA125）在男性患者中预测胃肠道恶性疾病的诊断准确性。2013年4月至6月，第二军医大学长海医院消化内科收治的120例连续男性患者入院后接受了CA125检测。总结了年龄、主要症状和最终诊断的数据。估计了CA125对恶性肿瘤的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）、阳性似然比（PLR）和阴性似然比（NLR），并进行了受试者工作特征（ROC）分析和曲线下面积（AUC）评估CA125在男性患者中的诊断价值。CA125在恶性肿瘤中的PPV、NPV、PLR和NLR分别为55%、69%、1.90和0.71。然而，我们发现血清CA125水平升高在有浆液性积液的男性患者中比在有恶性肿瘤的男性患者中更常见。CA125在浆液性积液中的PPV、NPV、PLR和NLR分别为85%、96%、12.70和0.09。在ROC分析中，CA125区分有浆膜腔积液患者和无浆液性积液患者的AUC值为0.96（95%置信区间，0.93 - 0.99）。在患有胃肠道疾病的男性患者中，CA125检测浆液性积液的准确性高于检测恶性肿瘤。男性患者进行CA125检测以诊断恶性肿瘤意义不大。
