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利用受试者工作特征(ROC) 曲线比较130 例胸腔积液患者胸水腺苷脱氨酶(ADA) 、癌胚抗原(CEA) 和乳酸脱氢酶(LDH)测定值,以鉴别结核性或恶性胸水。选择错误率最小的整数界值作为诊断参考值。结果发现诊断结核性胸水ADA 和CEAROC曲线下面积分别为0-93 ±0-01 和0-81 ±0-04 ,不仅都大于随机猜测面积0-5(z>2-58 ,P< 0-01) ,而且二者间的面积也有统计差异(z= 2-75 , P < 0-01) ,LDH 的ROC 曲线下面积为0-58 ±0-05 ,与面积0-5 无统计差异(z< 1-96 , P> 0-05) ;诊断恶性胸水:CEA和ADAROC曲线下面积分别为0-84 ±0-04 和0-91±0-03 ,都大于面积0-5(z> 2-58 , P < 0-01) ,但二者间的面积无统计差异(z= 1-49 , P > 0-05) 。LDH 的ROC曲线下面积为0-52 ±0-05 ,与面积0-5 无统计差异(z< 1-96 , P> 0-05) 。诊断界值:ADA鉴别结核性胸水:20u/L;CEA鉴别恶性胸水:9-0μg/L。强调ADA 增高和CEA 降低都有助于结核性胸水的诊断,但ADA优于CEA;CEA增高?
Using the receiver operating characteristic (ROC) curve to compare the values of pleural effusion adenosine deaminase (ADA), carcinoembryonic antigen (CEA) and lactate dehydrogenase (LDH) in 130 cases of pleural effusion to identify tuberculous or malignant Pleural effusion. Select the smallest integer error bound as the diagnostic reference value. The results showed that the areas under the curve of ADA and CEAROC in diagnosis of tuberculous pleural effusion were 0-93 ± 0-01 and 0-81 ± 0-04, respectively, not only greater than the random guess area 0-5 (z> 2-58, P <0- 01). There was also statistical difference between the two groups (z = 2-75, P <0-01). The area under the ROC curve of LDH was 0-58 ± 0-05, which was not statistically different from the area 0-5 z <1-96, P> 0-05). The area under the curve of CEA and ADAROC in diagnosis of malignant pleural effusion were 0-84 ± 0-04 and 0-91 ± 0-03, respectively, which were larger than the area 0-5 (z> 2-58, P <0-01), but no statistical difference between the two (z = 1-49, P> 0-05). The area under the ROC curve of LDH was 0-52 ± 0-05, with no statistical difference from 0-5 (z <1-96, P> 0-05). Diagnostic cutoffs: ADA differential tuberculous pleural effusion: 20u / L; CEA differential malignant pleural effusion: 9-0μg / L. Emphasize ADA increased and decreased CEA contribute to the diagnosis of tuberculous pleural effusion, but ADA is superior to CEA; CEA increased?