联合检测EBNA1-IgA和EA-IgG在鼻咽癌血清学诊断中的价值  

Value of EBNA1-IgA and EA-IgG in serological diagnosis of nasopharyngeal carcinoma

作　　者：张昌卿[1] 宗永生[2] 孙韵[1] 张玉[3] 林素暇[3] 叶永照[1] 冯凯涛[1] 梁英杰[2] 

机构地区：[1]中山大学附属肿瘤医院实验研究部,广州510060 [2]中山大学中山医学院病理学教研室 [3]中山大学附属肿瘤医院病理科,广州510060

出　　处：《中华肿瘤杂志》2004年第8期482-484,共3页Chinese Journal of Oncology

基　　金：国家自然科学基金资助项目 ( 3 973 0 90 0 II) ;"十五"国家科技攻关计划资助项目 ( 2 0 0 1BA70 3B0 7);广东省卫生厅基金资助项目 ( 19982 18)

摘　　要：目的　探讨联合检测EBNA1 IgA和EA IgG在鼻咽癌血清学诊断中的价值。方法　收集 5 6例未经治疗的鼻咽癌患者和 5 8例健康成年人血清 ,用酶联免疫吸附法 (ELISA)检测EBNA1 IgA和EA IgG ,比较其单独或联合检测的灵敏度、特异度、阳性预测值、正确率和优势比。结果　EBNA1 IgA的灵敏度 (91.0 7% )高于EA IgG(87.5 0 % ) ,EA IgG的特异度 (87.93% )高于EBNA1 IgA (84 .4 8% )。二者联合检测的特异度为 94 .83% ,阳性预测值为 0 .9375 ,阳性似然比为 15 .5 4 35 ,优势比为 75 .0 0 0 0。4 5例EBNA1 IgA阳性的鼻咽癌患者与EA IgG阳性结果相吻合 ;5例EBNA1 IgA阴性的鼻咽癌患者中 ,有 4例EA IgG阳性 ;7例EA IgG阴性的鼻咽癌患者中 ,有 6例EBNA1 IgA阳性。结论　EBNA1 IgA和EA IgG在血清学检测中有较高的灵敏度和特异度 ,二者联合检测有互补作用 ,可提高鼻咽癌血清学诊断的可靠性。大多数鼻咽癌患者为EBNA1 IgA和EAObjective To evaluate the value of EBNA1-IgA and EA-IgG in serological diagnosis of nasopharyngeal carcinoma (NPC). Methods The serum EBNA1-IgA and EA-IgG of 56 patients with NPC and 58 healthy adults were detected by ELISA. The sensitivity, specificity, positive predictive value, accuracy rate and odds ratio of the two tests used singly or in combination were compared with each other. Results The sensitivity of EBNA1-IgA (91.07%) was higher than that of EA-IgG (87.50%), while the specificity of EA-IgG (87.93%) was higher than that of EBNA1-IgA (84.48%). The combination of EBNA1-IgA and EA-IgG could enhance the specificity (94.83%), positive predictive value (0.9375), likelihood ratio (15.5435) and odds ratio (75.0000) for serological diagnosis of NPC. Forty-five patients showed both positive EBNA1-IgA and positive EA-IgG. A positive EA-IgG was detected in 4 out of 5 patients with negative EBNA1-IgA and a positive EBNA1-IgA was founded in 6 out of 7 patients with negative EA-IgG. Conclusion Although relatively high sensitivity and specificity could be obtained by either EBNA1-IgA or EA-IgG test alone, the combination of these two tests with a complementary effect is able to enhance the reliability of serological diagnosis of NPC as most patients have positive ENBA1-IgA and EA-IgG concurrently.

关 键 词：EBNA1-IgA EA-IgG 鼻咽癌 血清学 鼻咽肿瘤 病毒感染 

分 类 号：R739.63[医药卫生—肿瘤]