Application Of ROC Curve In The Analysis And Evaluation Of The Diagonstic Value Of The Combined Detection Of CEA,CA153 And CA242 In Lung Cancer With Pleural Effusion

[Object]To investigate the diagnostic value of the pleural effusion Carcinoembryonic Antigen(CEA),Carbohydrate Antigen 153(CA153),Carbohydrate Antigen 242 (CA242)and the combined detection CEA,CA153,CA242 in lung cancer.[Method]ROC curve was used to analyze the results about pleural effusion CEA, CA153,CA242 from 36 patients with lung cancer,22 benign pulmonary diseases.The concentration of CEA was determined by radioimmunoassay method.The concentrations of CA153 and CA242 were determined by immunoradiometricassay method.[Result](1)The pleural effusion level of CEA,CA153 and CA242 of lung cancer group was higher than that of the benign pulmonary disease group(P＜0.05);For lung squamous cell carcinoma,adenocarcinoma and small cell cancer,pleural effusion levels of CEA, CA153 and CA242 were higher than those of benign pulmonary disease group(P＜0.025);The difference between pneumonia and tuberculosis group was not statistically significant(P＞0.05);in addition to the difference of CA153 level between the lung squamous cell carcinoma and adenocarcinoma group had a significant difference(P＜0.017),the levels of CEA,CA153 and CA242 among the lung squamous cell carcinoma,adenocarcinoma and small cell lung cancer group,there was no significant difference(P＞0.017). (2)ROC curve showed that the under-curve area(AUC)of CEA,CA153 and CA242 were:0.859,0.909 and 0.831 respectively.The under-curve area of CA153 was the largest,The area of CA242 was the minimum.(3)According to ROC curve analysis,the clinical diagnostic critical points of CEA, CA153 and CA242 in patients with lung cancer were 7.76ug/L,23.33u/ml,12.61u/ml.(4)Individual testing,the sensitivities of CEA,CA153 and CA242 were 77.78%, 88.89%,80.56%respectively.(5)The combined detection of CEA+CA153,CA153+CA242,CEA+CA153+ CA242 of lung cancer with pleural effusion got the same sensitivity up to 88.89%, Combined detection of CEA+CA153 was better than other combinations by comprehensive evaluation.[Conclusion](1)The pleural effusion of CEA,CA153 and CA242 were useful for the diagnosis of malignant pleural effusion with lung cancer.(2)CA153 was the most efficient marker than CEA and CA242 in lung cancer diagnosis.CEA had better efficiency than CA242.(3)When sensitivity,specificity,accuracy and economy were considered,the best combined detection was CEA+CA153.