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Application of Multi-index Mathematical Model to Detect Malignant or Non-malignant Hydrathorax and Ascites

Author: LiZuo
Tutor: LinHong
School: Nanchang University
Course: Oncology
Keywords: hydrothorax ascites Mathematical model Differential diagnosis
CLC: R572;R730.4
Type: Master's thesis
Year: 2009
Downloads: 51
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Abstract


Objective To evaluate the significance of the incorporating hydrothorax and ascites measuremengt for the differentiation of malignancy-related and non-malignant by setting up and analyzing mathematical models .Methods Total 110 hydrothorax and ascites samples were collected which were devided to two groups.The number of the first group was 70. It included 35 patients with malignant hydrothorax and ascites, 18 patients with tuberculous hydrothorax and ascites and 17 no- tuberculous no-malignant hydrothorax and ascites. The number of the second group was 40,it included 15 patients malignant hydrothorax and ascites, 13 patients with tuberculous hydrothorax and ascites and 12 no- tuberculous no-malignant hydrothorax and ascites. The review research method was adopted . Index signs ,such as Alb（albumin,Alb）、VEGF（Vascular endothelial growth factor,VEGF）、CEA（Carcino-embryonic antigen,CEA）and ADA（Adenosine Deaminase ,ADA） in hydrothorax ,ascites and blood serum from patients with clear pathogeny were measured. To study specimen datas with Logistic regression analysis and ROC curve analysis, then established the mathematical model and diagnosis,the results were incorporated into the mathematical model,we got the prediction individual value of Pre-1 and Pre-2, in order to analyze the relationship between the incorporating measuremengt and the possibility of occurrence of a disease quantitivly, to compare sensitivity , specificity and accuracy between the incorporating measuremengt and the individual value. By statistics analysis,the clinical significance of the differentiation diagnosis between malignant or non-malignant hydrathorax and ascites was observed. ALB was measured by a automatic biochemistry analysis apparatus , CEA was measured by a radio immuno assay, ADA was measured by Chromogenic enzyme method ,VEGF was measured by an enzyme-linked immunosorbent assay.Results To study the index signs of the first group with Logistic regression analysis and ROC curve analysis, we have gotten two equations for the diagnosis of malignant and tuberculous hydrothorax and ascites. Such as P1 =1/ [1 + e- （ - 2. 083 - 0. ） 147X1 +0. 006X2 +0. 121X3 ] [X1 =AG value（Albumin gradient） ,X2 = VEGF value of hydrothorax and ascites,X3 =CEA value of hydrothorax and ascites], P2 = 1 / [ 1 + e- （ - 5. 607 - 0. 089X1 + 0. 366X2 + 0. 078X3 + 1. 564X4） ] （X1 =AG value,X2 = ratios of VEGF value,X3 =ADA value of hydrothorax and ascites,X4 = ratios of ADA value）. The individual value of Pre-1 and Pre-2 were calculated by the two equations ,the diagnostic points of which were 0.218 and 0.329. Among all,AG≥11.0g/L in all patients with transudate,while AG<11.0g/L in all ones with effusion. The sensitivity、specificity and diagnostic efficiency of AG、VEGF and CEA for the diagnosis of malignant or non-malignant hydrathorax and ascites were: 73.54%,39.97%,54.67%;87.24%,78.10%,73.56 and 51.73%,48.67%,35.46%.The sensitivity、specificity and diagnostic efficiency of ADA for the diagnosis of tuberculous hydrathorax and ascites were: 75.30%,58.79% and 23.26%.The sensitivity、specificity and diagnostic efficiency of Pre-1+Pre-2 for the diagnosis of malignant hydrathorax and ascites were: 83.90%,93.10% and 88.47%, The sensitivity、specificity and diagnostic efficiency of Pre-1+Pre-2 for the diagnosis of tuberculous hydrathorax and ascites were: 80.00%,92.01% and 88.71%.Conclusion The many index signs math model setted up by regression analysis contacts the project into one whole organ, to overcome the subjectivity and one-sidedness of diagnosis of many projects in the past,to improve the sensitivity、specificity and diagnostic efficiency of the index signs. There are certain clinical value of math model that it can differentiate malignant or non-malignant hydrathorax and ascites.

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