EB病毒膜潜伏蛋白LMP-1筛选鼻咽癌的初步结果  

The initial results of Epstein-Barr virus-encoded latent membrane protein-1 for screening nasopharyngeal carcinoma

作　　者：林少俊[1] 郭巧娟[1] 林锦[1] 宗井凤[1] 韩露[1] 潘建基[1] 

机构地区：[1]福建医科大学教学医院,福建省肿瘤医院放疗科,福建福州350014

出　　处：《中国癌症杂志》2010年第6期435-439,共5页China Oncology

基　　金：福建省卫生厅医学创新课题基金(2007-CXB-4)

摘　　要：背景与目的:早期诊断鼻咽癌是提高疗效的重要途径,而目前临床上用于鼻咽癌早期诊断的指标存在灵敏度及特异度不理想的问题,EB病毒膜潜伏蛋白LMP-1是目前被证实的具有转化功能的蛋白质之一,本研究旨在探讨LMP-1作为鼻咽癌筛选指标的价值。方法:收集2007—2008年期间以耳鼻咽喉症状到福建省肿瘤医院放疗科就诊并同意参加本试验的患者300例,利用鼻咽拭子法取鼻咽部黏膜脱落细胞,提取DNA,聚合酶链反应法(PCR法)检测LMP-1基因的表达,所有入组患者均行鼻咽组织病理活检明确诊断。结果:300份鼻咽拭子标本提取了有效DNA样本数243份,合格率81%。非鼻咽癌的患者及健康者中,LMP-1的阳性表达率为3.70%(4/108),明显低于鼻咽癌患者(P<0.05)。LMP-1诊断鼻咽癌的灵敏度为88.15%(119/135),特异度为96.30%(104/108),阳性预测值为96.75%(119/123),阴性预测值为86.67%(104/120),正确率为91.77%,Youden指数为84.45%。结论:利用PCR法检测鼻咽拭子中鼻咽黏膜脱落细胞EB病毒膜潜伏蛋白LMP-1的表达作为鼻咽癌筛选的指标可重复性好,具有较高的灵敏度和特异度,适合作为高危人群的筛查指标。Background and purpose： Early diagnosis ofnasopharyngeal carcinoma is an important method to improve the survival rate. However, the sensitivity and specificity of the screening protocols now widely used in clinic are considered unsatisfactory. Epstein-Barr virus （EBV） -encoded latent membrane protein-1 （LMP-1） is one of the protein that has been suggested to be a classic oncogene with transformation properties. The current study was set out to discuss the clinical significance of LMP-1 on the screening of nasopharyngeal carcinoma （NPC）. Methods： Three hundred patients who visited our institution with ENT symptoms between 2007 and 2008 were involved in this study, all of them were agreed to be involved in this investigation. Not only did they undergo nasopharyngeal swab to obtain ceils for the LMP-1 polymerase chain reaction （PCR） analysis, but also were taken nasopharyngeal biopsy to identify the diagnosis. Results： An amount of DNA that was sufficient for PCR was extracted from 243 （81%） swab samples, the positive rate of LMP-1 of those with non-nasopharyngeal carcinoma was 3.70% （4/108）, which was much lower than those with nasopharyngeal carcinoma （P〈0.05）. By detecting LMP-1 in nasopharyngeal swabs, NPC was diagnosed with a sensitivity of 88.15% （119 of 135 patients）, specificity of 96.30% （104 of 108 patients）, a positive predictive value of 96.75% （119 of 123 patients）, a negative predictive value of 86.67% （104 of 120 patients）, accuracy of 91.77%, and Youden index of 84.45%. Conclusion： The nasopharyngeal swab coupled with PCR-based EBV LMP-I detection has high sensitivity and specificity, as well as good repeatability, which could be served as part of a screening program for high-risk populations.

关 键 词：鼻咽癌 EB病毒 膜潜伏蛋白LMP-1 早期诊断 

分 类 号：R739.62[医药卫生—肿瘤] R730.43[医药卫生—临床医学]