Kobayashi H, Sumimoto K, Terao T, Kawashima Y
Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine.
Nihon Sanka Fujinka Gakkai Zasshi. 1989 Oct;41(10):1501-6.
The usefulness of tumor markers in serodiagnosis of cancer designed to detect ovarian cancer at an early stage was evaluated from the point of view of their diagnostic value. Namely, eight tumor markers, CA125, SLX, CA72-4, TPA, Fr, CEA, CA19-9, and SCC, were determined and studied to find the combination that would yield the optimal diagnostic value. For this purpose, the diagnostic value was calculated from sensitivity x specificity. As a single tumor marker CA125 proved optimal with a diagnostic value of 0.50. The higher value, 0.53, was obtained as the diagnostic value from the combination of two tumor markers, CA125 and CA72-4. When three tumor markers were combined, CA125, CA72-4 and SLX gave an optimal diagnostic value of 0.65. In the combination of four tumor markers, CA125, CA72-4, SLX and CA19-9 gave a diagnostic value of 0.63. In the five marker combination CA125, CA72-4, SLX, CA19-9 and TPA worked well and had a diagnostic value of 0.59. When the markers were increased to six types, CA125, CA72-4, SLX, CA19-9, TPA and Fr provided a combination with 0.53 as the diagnostic value. In the seven marker combination CA125, CA72-4, SLX, CA19-9, TPA, Fr and CEA gave a diagnostic value of 0.51. The efficiency declined to 0.51 when eight tumor markers were combined. When cost performance in the measurement of tumor markers for early detection of ovarian cancer is taken into account, a dilemma arises in that the increase in the number of tumor markers used is accompanied by higher sensitivity and lower specificity.(ABSTRACT TRUNCATED AT 250 WORDS)
从诊断价值的角度评估了肿瘤标志物在旨在早期检测卵巢癌的癌症血清学诊断中的实用性。具体而言,测定并研究了八种肿瘤标志物,即CA125、SLX、CA72 - 4、TPA、Fr、CEA、CA19 - 9和SCC,以找出能产生最佳诊断价值的组合。为此,根据敏感性×特异性计算诊断价值。作为单一肿瘤标志物,CA125的诊断价值为0.50,被证明是最佳的。两种肿瘤标志物CA125和CA72 - 4组合的诊断价值更高,为0.53。当三种肿瘤标志物组合时,CA125、CA72 - 4和SLX的最佳诊断价值为0.65。在四种肿瘤标志物组合中,CA125、CA72 - 4、SLX和CA19 - 9的诊断价值为0.63。在五种标志物组合中,CA125、CA72 - 4、SLX、CA19 - 9和TPA效果良好,诊断价值为0.59。当标志物增加到六种时,CA125、CA72 - 4、SLX、CA19 - 9、TPA和Fr的组合诊断价值为0.53。在七种标志物组合中,CA125、CA72 - 4、SLX、CA19 - 9、TPA、Fr和CEA的诊断价值为0.51。当八种肿瘤标志物组合时,效率降至0.51。考虑到用于早期检测卵巢癌的肿瘤标志物测量中的性价比时,会出现一个两难困境,即使用的肿瘤标志物数量增加伴随着更高的敏感性和更低的特异性。(摘要截断于250字)