联合检测EB病毒相关抗体和抗原对诊断鼻咽癌的价值  

Combined determination of Epstein-Barr virus-related antibodies and antigens for diagnosis of nasopharyngeal carcinoma

作　　者：罗耀凌[1,2] 欧国萍[1,3] 池沛冬[1,2] 梁永能[1,2] 刘宇辉 黄马燕[1,4] 

机构地区：[1]华南肿瘤学国家重点实验室,广东广州510060 [2]中山大学肿瘤防治中心检验科,广东广州510060 [3]中山大学肿瘤防治中心鼻咽癌科,广东广州510060 [4]中山大学肿瘤防治中心病理科,广东广州510060

出　　处：《癌症》2009年第1期96-99,共4页Chinese Journal of Cancer

摘　　要：背景与目的:近年来随着分子生物学的发展,提供了多项EB病毒(Epstein-Barr virus)相关的检测指标。本研究通过同时检测EB病毒VCA-IgA、EA-IgA、EBV-特异性DNA酶(EBV-DNase)抗体、EB病毒DNA(EBV-DNA),评价联合检测对诊断鼻咽癌的价值。方法:收集160例治疗前的鼻咽癌患者和76例健康成人的血清和血浆,应用免疫酶染色法检测血清VCA-IgA、EA-IgA;用正丁酸与巴豆油激发Raji细胞方法检测EBV-DNase抗体;用实时荧光定量聚合酶链反应(real-time fluorescence quantitative PCR,RQ-PCR)分析血浆EBV-DNA,评估其在诊断鼻咽癌中的价值。结果:单项检测时对鼻咽癌患者诊断的敏感性和特异性分别为:VCA-IgA90.0%、89.5%,EA-IgA75.0%、94.7%,EBV-DNase抗体76.3%、90.8%,EBV-DNA68.8%、88.2%。联合检测的敏感性和特异性分别为98.8%和84.2%。VCA-IgA、EA-IgA阳性率与临床分期无关(P﹥0.05),各临床分期中EBV-DNase抗体阳性率、EBV-DNA水平与阳性率的差异有统计学意义(P<0.05)。结论:VCA-IgA、EA-IgA、EBV-DNase和EBV-DNA单项检测时VCA-IgA敏感性最高,EA-IgA特异性最好;四项指标联合检测可提高鼻咽癌诊断的敏感性和准确度。EBV-DNase抗体、EBV-DNA有助于评估鼻咽癌病程和协助判断临床分期。Background and Objective： With the development of molecular biology in recent years, many indexes for detecting Epstein-Barr virus （EBV） have been developed. This study was to evaluate the diagnostic value of combined determination of EBV-related antibodies and antigens, including VCA-IgA, EA-IgA, EBV-DNase antibody and EBV-DNA, in diagnosing nasopharyngeal carcinoma （NPC）. Methods： Serum and plasma samples from 160 untreated NPC patients and 76 healthy donors were collected. VCA- IgA and EA-IgA in the serum samples were detected by immunoenzyme staining method. Raji cells were stimulated by ortho-butanoic acid and croton oil to detect EBV-DNase antibody. The content of EBV-DNA in the plasma samples was detected by real-time fluorescence quantitative polymerase chain reaction （RQ-PCR）. The diagnostic values of the indexes for NPC were evaluated. Results： The sensitivity and specificity for diagnosing NPC were 90.0% and 89.5% for VCA-IgA, 75.0% and 94.7% for EA-IgA, 76.3% and 90.8% for EBV-DNase antibody, 68.8% and 88.2% for EBV-DNA, and 98.8% and 84.2% for combined determination. The positive rates of VCA-IgA and EA-IgA had no relationship with clinical stage of NPC （P〉0.05）; nevertheless, the positive rates of EBV-DNase antibody and EBV-DNA were related with clinical stage （P〈0.05）. Conclusions： The sensitivity of VCA-IgA and the specificity of EA-IgA are the highest while detecting solely. Combined determination could improve the diagnostic sensitivity and accuracy for NPC. EBV-DNase antibody and EBV-DNA could be helpful to evaluate the course of disease and classify the clinical stage of NPC.

关 键 词：鼻咽肿瘤 诊断 EBV-特异性DNA酶抗体 EB病毒DNA 实时荧光定量聚合酶链反应 

分 类 号：R739.63[医药卫生—肿瘤]