Observation Of The Diagnostic Effects In The Partial Nonselective Tumor Based On The Combined Detection With Routine Test Indicators

Objective: To analyze the levels and diagnostic value of detecting indicators ofroutine blood test, routine biochemical test and tumor markers test in cancer patients,the accuracy of the combined detection were evaluated with ROC curve in order toobserve the diagnostic effect in the partial nonselective tumor based on the combineddetection with routine test indicators.Methods: We collected the fasting blood of cancer patients and people conductedhealth examination. The cancer group contained90cases (30cases of lung cancer,30cases of stomach cancer and30cases of liver cancer); the control group contained40cases which was randomly selected from healthy people; the validation group was260cases which contained152cases of cancer patients and108cases of healthy people;WBC, Neu#, LY#, RBC, HGB, PLT were detected by SYSMEX XE2100automaticblood analyzer with anticoagulated whole blood; AFU, ALB, ALP, ALT, AST, CHE, Cre,DBIL, GLU, hsCRP, LD, TBA, TBIL, TP, UA, UREA, β2-MG, γ-GT were detected byHitachi7600-020automatic biochemical analyzer with intravenous serum; AFP, CA125,CA15-3, CA19-9, CA72-4, CEA, CYFRA21-1, FER, NSE, PSA were detected byRoche E411electrochemical immunodetection analyzer with intravenous serum. ROCcurve were drawn and sensitivity, specificity, Youden index of test indicators werecalculated by SPSS19.0software, respectively. The diagnostic effects of indicatorswere evaluated with AUC.Results:1. Routine blood test results: The levels of LY#, RBC, HGB in cancer group wereless than those in the normal control group, with a very significant statistical difference(P<0.01).2. Routine biochemical test results: The level of UA in cancer group was less thanthat in the normal control group, with a significant statistical difference (P<0.05); The levels of ALB, CHE, TP in cancer group were less than those in the normal controlgroup, and the levels of ALP, hsCRP, TBA in cancer group were more than those in thenormal control group, with a very significant statistical difference (P<0.01).3. Tumor markers test results: The level of CA15-3in cancer group was more thanthat in the normal control group, with a significant statistical difference (P<0.05); thelevels of AFP, CA125, CA72-4, CEA, CYFRA21-1in cancer group were more thanthose in the normal control group with a very significant statistical difference (P<0.01).4. Evaluation of the diagnostic effect based on the combined detection with ROCcurve: with the corresponding medians of the normal control group as reference,combined detection of HGB, LY#, CHE, hsCRP, TP, AUC was0.889, when the cutoffvalue was3.5positive items, Youden index was0.658in maximum, the sensitivity was83.3%and the specificity was82.5%. To verify above-mentioned cutoff value in thecancer group, the positive rate of the lung cancer group, the gastric cancer patientsgroup, the liver cancer group were76.7%,83.3%,90.0%, respectively; Youden indexwere0.592,0.658,0.725, respectively. With the corresponding medians of the normalcontrol group as reference, combined detection of AFP, CA125, CA72-4, CEA,CYFRA21-1, AUC was0.796, when the cutoff value was2.5positive items, Youdenindex was0.481in maximum, the sensitivity was65.6%and the specificity was82.5%.To verify above-mentioned cutoff value in the cancer group, the positive rate of the lungcancer group, the gastric cancer patients group, the liver cancer group were86.7%,40.0%,70.0%, respectively; Youden index were0.650,0.225,0.525, respectively. Withthe corresponding medians of the normal control group as reference, combineddetection of HGB, LY#, CHE, hsCRP, TP, AFP, CA125, CA72-4, CEA, CYFRA21-1,AUC was0.937, when the cutoff value was5.5positive items, Youden index was0.714in maximum, the sensitivity was88.9%and the specificity was82.5%. To verifyabove-mentioned cutoff value in the cancer group, the positive rate of the lung cancergroup, the gastric cancer patients group, the liver cancer group were93.3%,80.0%,93.3%, respectively; Youden index were respectively0.758,0.625,0.758, respectively.There were the very significant statistical differences (P<0.01) among the AUCs ofthree diagnosis test groups.5. Validation of the diagnostic effect based on the combined detection of HGB,LY#, CHE, hsCRP, TP with ROC curve: in the validation group, the sensitivity was83.3%and the specificity was82.5%. There was no significant statistical difference (P>0.05) when compared with the experimental group.Conclusion: There were variations in indicators of routine blood test, routinebiochemical test and tumor markers test in cancer patients to different extents. Thesevariations may have tumor characteristic patterns. It is possible that the combineddetection with routine test indicators of HGB, LY#, CHE, hsCRP, TP could improve thediagnostic effects in the partial nonselective tumor.