CA242与CA72-4比值诊断早期结直肠癌的敏感度及特异度评价

目的评价肿瘤标记物CA242与CA72-4比值在诊断早期结直肠癌(CRC)的敏感度及特异度。方法收集87例CRC患者血标本,采用化学发光法检测CA242及CA72-4水平,采用受试者工作特征曲线(ROC)分析CA242/CA72-4比值在诊断CRC的敏感度与特异度。结果 87例疑似CRC患者最终56例(64.37%)被确诊为CRC,31例(35.63%)被排除CRC。CRC患者CA242、CA72-4及CA242/CA72-4比值均高于非CRC者,差异有统计学意义(P0.05),且以CA242/CA72-4比值最为明显(P=0.013)。CA242、CA72-4及CA242/CA72-4比值三者的曲线下面积(AUC)分别为0.754、0.621及0.775,其中CA72-4与早期CRC无明显相关性,而CA242及CA242/CA72-4比值与CRC诊断呈显著相关性(P=0.013、0.006),两者的95%可信区间(CI)分别为0.576~0.851及0.612~0.887;当CA242/CA72-4截值(cut-off)为2.6时(CA242=28.6,CA72-4=11时),其诊断早期CRC的敏感度为91.32%,特异度为94.57%。结论CA242/CA72-4比值在诊断早期CRC的敏感度及特异度均高于CA242或CA72-4两者单项,尤其当比值接近2.6时需高度注意CRC的可能。

Evaluation on sensitivity and specificity of CA242/CA72-4 ratio in diagnosing early colorectal carcinoma

Objective To evaluate the sensitivity and specificity of CA242/CA72‐4 ratio in diagnosing early colorectal carcino‐ma .Methods Totally 87 blood specimens of colorectal carcinoma(CRC) were collected .The Chemiluminescence method was adopt‐ed to detect the levels of CA242 and CA72‐4 .Then the receiver‐operating characteristic (ROC) curve was used to analyze the sensi‐tivity and specificity of CA242/CA72 4 ratio in the diagnosis of CRC .Results Among 87 cases of suspected CRC ,56 cases (64 .37% )were eventually diagnosed as CRC ,31 cases (35 .63% ) were excluded from CRC ;the CA242 and CA72‐4 levels and CA242/CA72‐4 ratios in the CRC group were higher than those in the non‐CRC group ,the differences were statistically significant (P<0 .05) ,moreover the CA242/CA72‐4 ratio was more significant(P=0 .013) .The areas under curve (AUC) of CA242 ,CA72‐4 and CA242/CA72‐4 ratio were 0 .754 ,0 .621 and 0 .775 respectively ,in which CA72‐4 had no significant correlation with the early CRC ,while CA242 and CA242/CA72‐4 ratio had significant correlation with the CRC diagnosis(P=0 .013 ,0 .006) and their 95%confidence intervals (CI) were 0 .576-0 .851 and 0 .612 -0 .887;when the CA242/CA72 4 cutoff value was 2 .6(CA242=28 .6 , CA72‐4=11) ,the sensitivity for early diagnosis of CRC was 91 .32% and the specificity was 94 .57% .Conclusion The sensitivity and specificity of CA242/CA72‐4 ratio in the early diagnosis of CRC are higher than those of CA242 or CA72‐4 single index ,espe‐cially w hen the ratio is close to 2 .6 ,high attention should be paid to the possibility of CRC .