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应用受试者工作特征(ROC)曲线分析 Tyrer-Cuzick 和 Gail 在江西省乳腺癌筛查中的应用。

Use of Receiver Operating Characteristic (ROC) Curve Analysis for Tyrer-Cuzick and Gail in Breast Cancer Screening in Jiangxi Province, China.

机构信息

Department of Galactophore, Affiliated Jiujiang Hospital of Nanchang University, Jiujiang, Jiangxi, China (mainland).

Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China (mainland).

出版信息

Med Sci Monit. 2018 Aug 9;24:5528-5532. doi: 10.12659/MSM.910108.

Abstract

BACKGROUND Breast cancer is a malignant tumor derived from breast gland epithelium. The screening and early diagnosis of breast cancer in high-risk populations can effectively suppress its threat to women's health and improve treatment efficiency, and thus has critical importance. Using various evaluation models, the present study evaluated cancer risk in 35-69-year-old women, and the usefulness of models in breast cancer prevention was compared. MATERIAL AND METHODS A total of 150 infiltrative breast cancer patients who were diagnosed with breast cancer at our hospital were recruited, along with 130 healthy women as the control group. A retrospective study was performed to collect information. The 5-year risk of breast cancer was evaluated using the Gail and Tyrer-Cuzick models. Diagnostic results were analyzed to plot ROC curves for comparing the value for screening between Gail and Tyrer-Cuzick models. RESULTS The Gail model has 53.33% sensitivity and 77.69% specificity, with 73.39% positive prediction value, 59.06% negative prediction value, 64.64% accuracy, and 0.31 Jordon index. The Tyrer-Cuzick model had 66.00% sensitivity, 86.92% specificity, 85.34% positive prediction value, 68.90% negative prediction value, 75.71% accuracy, and 0.53 Jordon index. The area under the curve (AUC) was 0.665 for the Gail model (95% CI: 0.6290.701) and 0.786 for the Tyrer-Cuzick model (95% CI: 0.7570.815). CONCLUSIONS Both Gail model and Tyrer-Cuzick models can be used to evaluate breast cancer risk. The Gail model has relatively lower accuracy in evaluating breast cancer risk in Jiangxi province of China and the Tyrer-Cuzick model had relatively higher accuracy.

摘要

背景

乳腺癌是一种源于乳腺腺上皮的恶性肿瘤。对高危人群进行乳腺癌筛查和早期诊断,能够有效遏制其对女性健康的威胁,提高治疗效率,具有重要意义。本研究采用多种评估模型对 35-69 岁女性进行了癌症风险评估,并比较了各模型在乳腺癌预防中的作用。

材料与方法

回顾性收集本院收治的 150 例浸润性乳腺癌患者的临床资料,另选取同期在本院体检的健康女性 130 例作为对照组。采用 Gail 模型和 Tyrer-Cuzick 模型对所有研究对象的 5 年乳腺癌发病风险进行评估,分析诊断结果绘制 ROC 曲线,比较 Gail 模型和 Tyrer-Cuzick 模型的筛查价值。

结果

Gail 模型的灵敏度为 53.33%,特异度为 77.69%,阳性预测值为 73.39%,阴性预测值为 59.06%,准确率为 64.64%,约登指数为 0.31。Tyrer-Cuzick 模型的灵敏度为 66.00%,特异度为 86.92%,阳性预测值为 85.34%,阴性预测值为 68.90%,准确率为 75.71%,约登指数为 0.53。Gail 模型曲线下面积(AUC)为 0.665(95%CI:0.6290.701),Tyrer-Cuzick 模型 AUC 为 0.786(95%CI:0.7570.815)。

结论

Gail 模型和 Tyrer-Cuzick 模型均可用于评估中国江西地区女性乳腺癌发病风险,Gail 模型评估乳腺癌发病风险的准确率相对较低,Tyrer-Cuzick 模型评估乳腺癌发病风险的准确率相对较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e24c/6097135/2ae764e2c8a1/medscimonit-24-5528-g001.jpg

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