ROC曲线评价3项标记物诊断子宫内膜异位症的价值

目的：比较子宫内膜异位症（EMs）标记物的诊断价值。方法：选择开腹术后病理检查诊为EMs的40例患者为EMs组,同期入院经术后病理检查非EMs者34例为对照组。分别采用放射免疫法及免疫放射法测定血清及腹腔液中白细胞介素6（IL-6）、肿瘤坏死因子α（TNF-α）和CA125血清浓度和腹腔液浓度,绘制EMs组IL-6,TNF-α和CA125血清浓度和腹腔液浓度的ROC曲线,计算曲线下面积。结果：①EMs组3项标记物的血清浓度高于对照组,组间比较差异均有统计学意义（P〈0.05）。②EMs组腹腔液IL-6和TNF-α浓度分别高于对照组,组间比较差异有统计学意义（P〈0.05）;而EMs组腹腔液中CA125的浓度与对照组比较差异无统计学意义（P〉0.05）。③EMs组血清3项标记物浓度与对应腹腔液中浓度无线性相关性（P〉0.05）。④EMs组腹腔液TNF-α、血清TNF-α、血清CA125、腹腔液IL-6、血清IL-6、腹腔液CA125的ROC曲线下面积分别为0.902,0.856,0.790,0.778,0.700和0.403。结论：腹腔液TNF-α有望成为临床诊断EMs更有价值的指标。

The Application of ROC Curve to Appraising the Prognosis Value of Three Markers in Endometriosis

Objective：To compare the diagnosis value of endometriosis（EMs） markers.Methods：Forty cases with EMs（EMs group）and thirty-four cases without EMs（control group） which were diagnosed through pathological sections after opening appendectomys were enrolled in this study.Levels of interkin-6（IL-6）,tumor necrosis factor-alpha（TNF-α） and CA125 in serum and portioned fluid（PF） were detected by radioimmunoassay and immunoradiometric assay in them,we drew the ROC curves of EMs group,serum and PF and counted out their areas under the ROC curves.Results：In EMs group,the concentrations of three markers in serum were elevated significantly compared with those in the control group（P 0.05）.In EMs group,the concentrations of IL-6 and TNF-α in PF were elevated significantly compared with those in the control group（P 0.05）,but no significant difference was found in CA125 of PF（P 0.05）.In EMs group,there were no positive correlation between the levels of three markers in serum and in PF（P0.05）.In EMs group,the areas under the ROC curves of TNF-α in PF,TNF-α in serum,CA125 in serum,IL-6 in PF,IL-6 in serum,CA125 in PF were 0.902,0.856,0.790,0.778,0.700and 0.403 respectively.Conclusions：TNF-α in PF could hopefully be used as a diagnostic marker.