, Volume 10, Issue 11, pp 650-653

Evaluation of the diagnostic value of tumor markers with ROC and logistic regression in gastrocolic tumors

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The aim of the study was to evaluate the clinical significance of multiple tumor markers (CEA, AFP, CA72-4 and CA19-9) in patients with gastrocolic tumors by receiver operating characteristic (ROC) curve and stepwise logistic regression (LR) analysis.


The serum concentrations of CEA, AFP, CA72-4 and CA19-9 were measured with electrochemiluminescence immunoassay in 126 patients with gastrocolic tumors, 137 patients with benign gastrocolic disorders and 109 healthy controls. The area under the ROC curve (AUC) of CEA, AFP, CA72-4 and CA19-9 and stepwise LR results were compared by sensitivity, specificity, Youden’s index and positive likelihood ratio/negative likelihood ratio.


The levels of four tested tumor markers in patients with gastrocolic tumors were significantly higher than those in benign gastrocolic group and normal controls. In the benign gastrocolic group, the AUC from stepwise logistic regression was larger than the AUC of four tumor markers respectively. Sensitivity, Youden’s index and positive likelihood ratio/negative likelihood ratio were the highest in the combination assay of CA72-4, CEA, and CA19-9, as compared with one of the tumor markers alone.


The use of ROC established by LR analysis model improved the diagnostic accuracy of gastrocolic tumors. For the screening of gastrocolic tumors, the AUC value of the combination probability index (sensitivity and specificity) was significantly higher than the values of the different tumour markers.

Supported by grants from Major Project Grant of Department of Education of the Sichuan Province (No. 09ZA045), the Public Health Project Grant of Sichuan Province (No. 100258) and the Affiliated Hospital of Luzhou Medical College (No. 201143).