Biological Measures for Early Detection of Pre-invasive and Invasive Carcinoma of Gastrium: A Bayesian Approach
Date Issued
2004
Date
2004
Author(s)
Hsu, Hsiu-Ching
DOI
en-US
Abstract
前言：最近部分研究以血清生化指標使用於胃癌篩檢，但是生化指標的切點在各個研究並無定論，尤其並沒有將年齡以及平衡偽陰性與偽陽性所決定的風險值列入考慮。
目的：以貝氏分析應用於胃癌及腸型化生之個別風險評估。
方法：將相關的生化指標以對數及平方根轉換使之符合常態分佈。透過貝氏方法進行單變項及雙變項分析。研究資料來自於馬祖地區所進行的胃癌及癌前病變社區篩檢，運用蒙地卡羅馬可夫鏈估計後驗風險比值及95%信賴區間。
結果：除了年齡因素，胃蛋白脢原I為診斷胃癌最重要的指標，其次為癌胚抗原，兩者具有邊緣統計上相關。在腸型化生以幽門螺旋桿菌感染分層，胃蛋白脢原I及胃蛋白脢原I/II比率為統計上顯著相關的因子。將上述因子進行單變項及雙變項分析，計算後驗風險比。再以預先訂定的風險值及效用比，求得適當的切點以及相對的敏感度及特異度。
結論：由方法學的角度而言，我們以貝氏分析模式進行個別胃癌及腸型化生的預測。由胃癌及癌前病變的篩檢角度而言，再以生化指標作為篩檢工具，對於切點的選擇本研究對於政策的擬定有很大幫助。
Background: The recently proposed serum marker for gastric cancer screening has been criticized by lacking of appropriate cutoff point determined by age and predetermined risk level related to the trade-off between false negative cases and false positive cases.
Objective: A Bayesian model was proposed to estimate individual risk for gastric cancer or intestinal metaplasia.
Methods: Univariate and bivariate analysis using Bayesian approach were developed assuming normal distributions after log or square transformation of relevant serum markers. This model was applied to data from community-based screening for gastric cancer or its precursor in Matzu. Monte Carlo Markov Chain (MCMC) simulation was applied to estimate posterior odds ratios and 95% confidence interval.
Results: In addition to age, PG I was selected the most important marker for ascertaining cancer and CEA was of borderline statistical significance. Similarly, PGI and PGI /PG II ratio were two significant factors for predicting IM after the stratification of the presence of HP infection. Posterior odds were all calculated for univariate and bivariate analysis. The selected cutoff points in relation to sensitivity and specificity given predetermined risk level and utility ratio were demonstrated.
Conclusions: From the methodological viewpoint, we developed a Bayesian model for individual risk prediction for gastric cancer or intestinal metaplasia. From the aspect of screening for gastric cancer or precursor, this approach plays an important role in mass screening for gastric cancer or its precursor with serum marker.
Subjects
蒙地卡羅馬可夫鏈
貝氏分析
生化指標
胃癌
biological measures
Monte Carlo Markov Chain
Bayesian model
gastric cancer
SDGs
Type
thesis
File(s)![Thumbnail Image]()
Loading...
Name
ntu-93-R91846010-1.pdf
Size
23.31 KB
Format
Adobe PDF
Checksum
(MD5):c473979e229f291ed9f7cae1cd72d7d6