Key words evaluation; lung cancer; tumor markers; diagnosis
Since the 1980s, the tumor markers (tumor marker, TM) have a lot, and also many associated with lung cancer TM. TM detection technology performance evaluation and clinical diagnostic performance evaluation of TM indicators detect a lack of specificity and sensitivity of utmost importance. In this paper, carcinoembryonic antigen (CEA), neuron-specific enolase enzyme (NSE), cytokeratin 19 fragment (CYFRA21 1), carbohydrate antigen (CA 125) and its joint detection for sensitivity, specificity, positive predictive value, negative predictive value, youden Index (effectiveness), positive likelihood ratio, negative likelihood ratio analysis of the ROC curve (area), and indicators as the evaluation of the performance of the clinical diagnosis of lung cancer.
1 Data and methods
Used in the case group were 2006 hospital inpatients. (1) 114 cases of lung cancer patients (all diagnosed by pathological examination). 80 cases were male and 34 females, aged 41 to 82 years old; including 19 cases of small cell lung cancer, non-small cell lung cancer, 95 cases (45 cases of squamous cell carcinoma, and adenocarcinoma in 50 cases); seven cases of clinical stage Ⅰ, Ⅱ of 52 cases, Ⅲ 40 cases, 15 cases, Ⅳ stage. (2) 61 cases of benign lung disease, clinical, radiologic, and laboratory tests confirmed after treatment, to the exclusion of the tumor, 36 males and 25 females, aged 35 to 80 years old; including bronchitis in 17 cases, 29 cases of pneumonia, 15 cases of asthma. (3) normal 30 cases of healthy persons to the hospital are adult, male 19 cases, 11 females, aged 30 to 60 years old. Benign lung disease, normal people are classified as the control group.
1.2 TM detection
Since my hospital for medical treatment first detected TM results for the analysis of the data (to accept the results of the the TM test report before treatment). 5ng/ml为阳性，仪器ACCESS，试剂BECKMAN；CYFRA211、NSE用免疫放射方法，CYFRA211>3.30ng/ml为阳性，NSE>13.6ng/">TM detection method: the CEA chemiluminescence detection value> 5ng/ml positive, instruments the ACCESS, reagents BECKMAN; CYFRA21 1, NSE IRMA method, CYFRA21 1> 3.30ng/ml positive, NSE in 13.6ng, / 41U/ml为阳性；试剂为北京科美东雅生物试剂；放免（免放）仪器为SN682型γ计数">ml as positive, reagents for the company’s products in CIS, France; CA 125 IRMA method, the detection value> 41U/ml positive; reagent was the Beijing Chemclin biological reagents; instrument for SN 682 γ count radioimmunoassay (Free release) instrument. The joint detection result: there is one or more than one positive, as the joint testing positive.
1.3 statistical methods
CEA, NSE, CYFRA21 1, CA 125 and joint detection ROC curve using the SPSSL1.5 produce, which combined detection of first Logistic regression, formation of joint detection factor, further ROC curve.
Of 2.1 lung TM joint detection project selection
The sensitivity and specificity of the three joint detection method, are shown in Table 1, the ROC curve shown in Figure 1 (the area see table 1), the ROC area for judging indicators, NSE + CYFRA21 1 + CEA + CA 125 for the best . Table 1 TM joint detection (114 cases of lung cancer group, the control group, 91 cases)
Since the 1980s, TM have a lot of lung cancer TM also many. Commonly used in lung cancer related TM: CEA, NSE, CYFRA21 1, CA 125 lung cancer-associated antigen (LTA), vascular endothelial growth factor (VEGF), proliferating cell nuclear antigen (PCNA), epidermal growth factor receptor (EGFR) [1 2, due to the various TM indicators detect the lack of specificity and sensitivity, to detect and reasonable application of TM, experts and scholars have Comments [3 5]. TM detection technology performance evaluation and clinical diagnostic performance evaluation is an important guarantee of the proper use of TM. TM detection technology or TM test results as well as the joint detection applications more reports [6-TM results predict outcomes research .
With the further development of detection technologies, the specification of the experimental operation, quality control requirements, technical performance of the experimental methodology basic guaranteed. Clinical diagnostic performance evaluation of the test items used in medical decision-making is very important for the diagnosis and rule out misdiagnosis. How to look at a (more) positive or negative detection project indicators, the possibility of the disease can be confirmed or excluded based on the detection project indicators be? There is the analysis of the test results to determine whether to consider the different parts of the tumor incidence? TM diagnostic performance evaluation of the above problems, there must help. Clinicians to master the knowledge of the evaluation and interpretation of test in a timely manner to make a choice or flexibility in the use of diagnostic tests, not only improve the quality of their own business, to ensure that the correct diagnosis and proper treatment, but also to reduce patients unnecessary financial expenditure, better services for patients.
In short, the TM application must be scientific, careful and comprehensive evaluation. Prevent the machine reads the data, blind judge, it will be more conducive to clinical diagnosis and treatment.