Department of Clinical Laboratory, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China.
Dis Markers. 2018 Oct 1;2018:2082840. doi: 10.1155/2018/2082840. eCollection 2018.
The detection of serum biomarkers can aid in the diagnosis of lung cancer. In recent years, an increasing number of lung cancer markers have been identified, and these markers have been reported to have varying diagnostic values. A method to compare the diagnostic value of different combinations of biomarkers needs to be established to identify the best combination. In this study, automatic chemiluminescence analyzers were employed to detect the serum concentrations of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), cytokeratin 19 fragment (CY211), neuron-specific enolase (NSE), and squamous cell carcinoma antigen (SCC) in 780 healthy subjects, 650 patients with pneumonia, and 633 patients with lung cancer. Receiver operating characteristic (ROC) curve and logistic regression analyses were also used to evaluate the diagnostic value of single and multiple markers of lung cancer. The sensitivities of the five markers alone were lower than 65% for lung cancer screening in healthy subjects and pneumonia patients. SCC was of little value in screening lung cancer. After combining two or more markers, the areas under the curves (AUCs) did not increase with the increase in the number of markers. For healthy subjects, the best marker for lung cancer screening was the combination CEA + CA125, and the positive cutoff range was 0.577 CEA + 0.035 CA125 > 2.084. Additionally, for patients with pneumonia, the best screening markers displayed differences in terms of sex but not age. The best screening marker for male patients with pneumonia was the combination CEA + CY211 with a positive cutoff range of 0.008 CEA + 0.068 CY211 > 0.237, while that for female patients with pneumonia was CEA > 2.73 ng/mL, which could be regarded as positive. These results showed that a two-marker combination is more suitable than a multimarker combination for the serological screening of tumors. Combined ROC curve and logistic regression analyses are effective for identifying the best markers for lung cancer screening.
血清标志物的检测有助于肺癌的诊断。近年来,越来越多的肺癌标志物被发现,这些标志物的诊断价值报道不一。需要建立一种方法来比较不同标志物组合的诊断价值,以确定最佳组合。本研究采用全自动化学发光分析仪检测了 780 例健康体检者、650 例肺炎患者和 633 例肺癌患者血清癌胚抗原(CEA)、糖类抗原 125(CA125)、细胞角蛋白 19 片段(CY211)、神经元特异性烯醇化酶(NSE)和鳞状细胞癌抗原(SCC)的浓度。采用受试者工作特征(ROC)曲线和 logistic 回归分析评估单个和多个肺癌标志物的诊断价值。五项标志物单独用于健康体检者和肺炎患者肺癌筛查的灵敏度均低于 65%。SCC 对肺癌筛查价值不大。联合两种或更多标志物后,曲线下面积(AUC)并不随标志物数量的增加而增加。对于健康体检者,CEA+CA125 组合是肺癌筛查的最佳标志物,阳性截断值范围为 0.577 CEA+0.035 CA125>2.084。此外,对于肺炎患者,最佳筛查标志物在性别上存在差异,但与年龄无关。肺炎男性患者最佳筛查标志物为 CEA+CY211 组合,阳性截断值范围为 0.008 CEA+0.068 CY211>0.237,而肺炎女性患者最佳筛查标志物为 CEA>2.73ng/ml,可视为阳性。这些结果表明,与多标志物组合相比,双标志物组合更适合肿瘤的血清学筛查。联合 ROC 曲线和 logistic 回归分析有助于确定肺癌筛查的最佳标志物。
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