摘要
目的 同时检测EB病毒（EBV） Rta-IgG、衣壳抗原（VCA）-IgA、早期抗原（EA）-IgA、EBV-DNA,评价EBV血清学联合检测在鼻咽癌诊断中的价值.方法 收集2012年1-12月中山大学肿瘤防治中心经病理确诊的131例治疗前鼻咽癌、52例非鼻咽癌的相似症状患者和148名健康体检者的血清和血浆,应用免疫酶染色法检测血清VCA-IgA、EA-IgA抗体;ELISA法检测Rta-IgG抗体;用实时荧光定量PCR分析血浆EBV-DNA.比较单独应用和联合应用各指标在鼻咽癌血清学诊断中的敏感度和特异度.结果 鼻咽癌组Rta-IgG、VCA-IgA、EA-IgA、EBV-DNA阳性率均高于鼻咽相关疾病组及健康对照组（均P＜0.01）.Rta-IgG、EBV-DNA阳性率及EBV-DNA水平随鼻咽癌临床分期增高而增高（均P ＜0.05）;VCA-IgA、EA-IgA阳性率与鼻咽癌临床分期无关（P＞0.05）.Rta-IgG和EBV-DNA的受试者工作特征曲线下面积分别为0.901和0.827,4个指标对鼻咽癌血清学诊断效能均较好,单项检测的敏感度和特异度分别为：Rta-IgG：77.9％ 、92.5％,VCA-IgA：93.1％、91.5％,EA-IgA：74.8％、99.5％,EBV-DNA：64.9％、97.0％;联合检测的敏感度和特异度分别为97.7％、83.5％.结论 联合检测Rta-IgG、VCA-IgA、EA-IgA、EBV-DNA可提高EBV血清学在鼻咽癌诊断中的效益.
Objective To evaluate the values of combined detection method of EB viral Rta-IgG,VCA-IgA,EA-IgA and EB viral DNA in the diagnosis of nasopharyngeal carcinoma （NPC）.Methods Serum and plasma samples from 131 untreated NPC patients,52 non-NPC patients with NPC-like symptoms and 148 healthy donors from January to December 2012 were collected.Immunoenzymatic staining was used to detect VCA-IgA and EA-IgA in sera.ELISA was performed to detect Rta-IgG antibody in sera and realtime fluorescent quantitative PCR for measuring EBV DNA in plasma.The clinical characteristics of 3 groups were compared.ROC curve and correlation analyses were performed to assess the detection assays for the diagnosis of NPC.Results The positive rates of EBV Rta-IgG,VCA-IgA,EA-IgA and EBV DNA in untreated NPC patient group were higher than those in other two groups.The differences were statistically significant （all P ＜0.01）.The differences of Rta-IgG antibody positive rates,EBV-DNA levels and EBV-DNA positive rates at different clinical stages were statistically significant （all P ＜ 0.05）.The positive rates of VCA-IgA and EA-IgA were not related with clinical stages （P ＞ 0.05）.Areas under ROC curve for RtaIgG and EBV-DNA were 0.901 and 0.827 respectively.All four diagnostic assays demonstrated excellent efficiency.The sensitivity and specificity of individual assays were as follows：Rta-IgG：77.9％,92.5％ ;VCA-IgA 93.1％,91.5％ ; EA-IgA：74.8％,99.5％ ; EBV-DNA 64.9％,97.0％.The sensitivity and specificity of combined assays were 97.7％ and 83.5％ respectively.Conclusion Combined detection method of EB viral Rta-IgG,VCA-IgA,EA-IgA and EB viral DNA are efficient for the diagnosis of NPC.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第44期3516-3519,共4页
National Medical Journal of China
