定量检测EB病毒VCA-IgA和EA-IgA抗体对EB病毒相关鼻咽癌的诊断意义  

Quantitative assay of Epstein-Barr virus specific VCA-IgA and EA-IgA antibodies for diagnosing nasopharyngeal carcinoma

作　　者：陈云[1] 刘根焰[2] 姚堃[1] 徐洁洁[3] 卢士强[1] 程冉[4] 梁志超[4] 崔屹[5] 

机构地区：[1]南京医科大学微生物免疫学系,江苏南京210029 [2]南京医科大学第一附属医院检验科,江苏南京210029 [3]南京医科大学第一附属医院耳鼻咽喉科,江苏南京210029 [4]江苏省肿瘤医院检验科,江苏南京210009 [5]中国药科大学生命科学与技术学院,江苏南京210009

出　　处：《南京医科大学学报（自然科学版）》2009年第12期1638-1642,共5页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金资助(30571715,30901750);江苏省实验诊断学重点实验室基金(XK200731);江苏省人事厅六大人才高峰资助(07-B-037)

摘　　要：目的:评价EB病毒特异性VCA-IgA和EA-IgA抗体定量检测对EB病毒相关的鼻咽癌的诊断意义。方法:试验组为228例鼻咽癌血清标本,对照组为102例正常健康体检者血清标本。用ELISA法定量检测血清标本中EBV特异性VCA-IgA和EA-IgA抗体水平,以临床病理诊断为金标准,分析各血清检测指标的准确性、灵敏性、特异性及其cut-off值的设定。结果:正常健康人血清中EB病毒特异性VCA-IgA和EA-IgA抗体的平均水平分别为15U/ml和11.5U/ml,鼻咽癌患者血清中VCA-IgA和EA-IgA抗体的平均水平分别为56.5U/ml和63.5U/ml,鼻咽癌组抗体水平显著高于健康体检组。根据VCA-IgA、EA-IgA定量检测结果绘制ROC曲线图,曲线下面积分别为0.903和0.948,VCA-IgA、EA-IgA定量检测可用于鼻咽癌的准确诊断。根据ROC曲线图分析,cut-off值分别设定为30U/ml和23U/ml。按此值设定时,VCA-IgA检测鼻咽癌的敏感性和特异性分别为84.9%和66.8%,EA-IgA检测鼻咽癌的敏感性和特异性分别为87.9%和91.1%。联合检测VCA-IgA和EA-IgA的敏感性为92%,特异性为91%。结论:以ELISA法定量检测VCA-IgA、EA-IgA的血清抗体水平对鼻咽癌具有诊断意义,尤其将两指标联合应用。Objective：To evaluate the diagnostic value of quantitative assay of EB virus specific antibodies to VCA-IgA and EA-IgA on diagnosing and screening of EB virus related nasopharyngeal carcinoma （NPC）. Methods：The test panel consisted of 228 sera from NPC patients and 102 sera of healthy controls. For each specimen,immunoglobulin A antibodies to EBV-specific VCA（viral capsid antigen） and EA（early antigen） were quantitatively tested with enzyme linked immune absorbed assay respectively. Compared with the clinical pathologic diagnosis,the accuracy,sensitivity,specificity and cut-off value of each biomarker were analyzed. Results： The mean value of EB virus specific VCA-IgA and EA-IgA antibodies were 15 U/ mL and 11.5 U/ ml among healthy population;56.5 U/ ml and 63.5 U/ ml among NPC patients,each one’s level was significant higher in NPC patients than that in healthy population. VCA-IgA and EA-IgA can be used in diagnosing NPC accurately with 0.903 and 0.948,area under the ROC curve respectively. Through ROC curve analysis,the best cut-off values of VCA-IgA and EA-IgA were 30 U/mL and 23 U/ml. At this level,the sensitivity and specificity for diagnosing NPC were 84.9% and 66.8% for VCA-IgA,87.9% and 91.1% for EA-IgA,and 92% and 91% for combined determination. Conclusion：Quantitative detection of VCA-IgA and EA-IgA antibodies with ELISA method is very valuable in diagnosing NPC,especially combined determination.

关 键 词：鼻咽癌 EB病毒 病毒衣壳抗原 早期抗原 ELISA 

分 类 号：R739.62[医药卫生—肿瘤]