Logistic回归及ROC曲线综合评价AFP、AFU、VEGF联合检测对原发性肝癌的诊断价值

目的应用Logistic回归及ROC曲线探讨甲胎蛋白（AFP）、α-L-岩藻糖苷酶（AFU）和血管内皮生长因子（VEGF）3项肿瘤标志物单项检测及联合检测对原发性肝癌（PHC）的诊断价值。方法收集原发性肝癌（PHC）组患者71例,慢性肝炎（慢肝）组患者58例,健康对照（对照）组39例,同时检测血清AFP、AFU、VEGF。应用Logistic回归模型,绘制ROC曲线并计算曲线下面积（AUC）来评价各指标的诊断价值。结果①PHC组患者血清AFP中位数为19.05、AFU中位数为25.80,均高于慢肝组的2.88及16.15,和对照组的2.50及15.00,有显著性差异（P〈0.01）。②PHC组患者血清VEGF水平中位数为227.28高于对照组的103.17,两组有显著性差异（P〈0.01）,而与慢肝组的167.90相比,无显著性差异（P〉0.05）。AFP、AFU、VEGF3项联合检测诊断PHC的ROC曲线下面积（AUC）为0.96,高于各指标单项检测的AUC,分别为0.87、0.75、0.75。结论 AFP、AFU、VEGF联合检测有助于提高PHC的诊断效能,3项联合检测优于各指标单项检测。

Comprehensive evaluation of the diagnostic value of the combined examination of AFP, AFU and VEGF for primary hepatic carcinoma by logistic regression and ROC curve

Objective To explore the diagnostic value of AFP,AFU,VEGF and the combined examination of AFP,AFU,VEGF for primary hepatic carcinoma（PHC） by a model of logistic regression and ROC curve.Methods Serum AFP,AFU and VEGF were determined in 71 cases with PHC,58 cases with chronic hepatitis and 39 normal control cases.Applied logistic regression,plotted ROC curve and calculated the area under ROC curve（AUC） to assess the diagnostic value of each index.Results The serum AFP and AFU level of PHC group were higher than chronic hepatitis group and normal control group,showing significant statistical difference（P〈0.01）（PHC group：median of AFP was 19.05,median of AFU was 25.80;chronic hepatitis group：median of AFP was 2.88,median of AFU was 16.15;normal control group：median of AFP was 2.50,median of AFU was 15.00）.The serum VEGF level of PHC group was higher than normal control group,showing significant statistical difference（P〈0.01）,and showing no significant statistical difference comparing with chronic hepatitis group（P 〉0.05）（PHC group：median of VEGF was 227.28;chronic hepatitis group：median of VEGF was 167.90;normal control group：median of VEGF was 103.17）.The AUC of the combined examination of AFP,AFU and VEGF for PHC was 0.96,higher than the AUC of AFP,AFU and VEGF single index examinations,which was 0.87,0.75 and 0.75 respectively.Conclusion The combined examination of AFP,AFU and VEGF for PHC is superior to any single index examination and it can greatly increase the detecting ability of PHC.