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目的定量检测血清肿瘤标志物鳞状细胞癌相关抗原(SCC-Ag)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)、铁蛋白(Ferritin)的表达水平,建立数学模型探讨血清肿瘤标志物在宫颈鳞癌诊断中的价值。方法收集宫颈鳞癌患者血液标本60例、上皮内瘤变患者血液标本53例,健康对照组血液标本70例,应用化学发光法同时检测血清上述指标。通过Logistic逐步回归筛选出有意义指标,运用ROC曲线评价肿瘤指标在宫颈鳞癌诊断中的价值。结果宫颈鳞癌组血清各肿瘤标志物SCCAg、CA125和CA19-9的含量显著高于健康对照组和上皮内瘤变组,差异有统计学意义(P<0.05)。三项血清肿瘤标志物SCCAg、CA125和CA19-9进入Logistic回归方程,对应曲线下面积分别为0.85、0.53和0.56。SCC-Ag、CA125、CA19-9三项联合检测的预测概率诊断宫颈鳞癌的AUC为0.91,敏感性、特异性、诊断准确率分别为90.12%、78.19%和83.60%,高于各单项检测指标。结论单项检测指标中SCC-Ag诊断宫颈鳞癌价值最高,Logistic回归和ROC曲线应用于多项指标联合检测宫颈鳞癌的分析评价,能提高诊断的敏感性和诊断准确率。
Objective To quantitatively detect the expression levels of serum tumor markers SCC-Ag, carbohydrate antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9) and ferritin, and to establish a mathematical To investigate the value of serum tumor markers in the diagnosis of cervical squamous cell carcinoma. Methods Sixty patients with squamous cell carcinoma of the cervix, 53 patients with intraepithelial neoplasia and 70 healthy controls were enrolled in this study. Chemiluminescence was used to detect the above indexes simultaneously. Logistic stepwise regression was used to screen out meaningful indicators, and to evaluate the value of tumor markers in the diagnosis of cervical squamous cell carcinoma by ROC curve. Results The serum levels of SCCAg, CA125 and CA19-9 in cervical squamous cell carcinoma were significantly higher than those in healthy control group and intraepithelial neoplasia group (P <0.05). Three serum tumor markers SCCAg, CA125 and CA19-9 entered the Logistic regression equation with corresponding areas under the curves of 0.85, 0.53 and 0.56, respectively. The AUC of predictive probability of SCC-Ag, CA125 and CA19-9 in diagnosis of cervical squamous cell carcinoma was 0.91, the sensitivity, specificity and diagnostic accuracy were 90.12%, 78.19% and 83.60% respectively, which were higher than those of single detection index. Conclusion SCC-Ag diagnosis of cervical squamous cell carcinoma has the highest value in single detection index. Logistic regression and ROC curve are used in the evaluation of cervical squamous cell carcinoma combined with multiple indexes, which can improve the diagnostic sensitivity and diagnostic accuracy.