提高EB病毒血清学在诊断鼻咽癌中的效益  

Enhancing the efficiency of Epstein-Barr viral serologic test in the diagnosis of nasopharyngeal carcinoma

作　　者：张昌卿[1] 宗永生[2] 黄宝珍[3] 孙韵[1] 叶永照[1] 冯凯涛[1] 李经略[1] 张锋[4] 

机构地区：[1]中山大学肿瘤医院中心实验室,广州510060 [2]中山大学中山医学院病理学教研室 [3]中山大学肿瘤研究所 [4]中山大学肿瘤医院鼻咽科

出　　处：《中华肿瘤杂志》2002年第4期356-359,共4页Chinese Journal of Oncology

基　　金：国家自然科学基金资助项目 (3 973 0 2 0 0 Ⅱ );广东省卫生厅基金资助项目 (1 9982 1 8)

摘　　要：目的　探讨同时应用VCA IgA、EA IgA和EA IgG三项检测在血清学诊断鼻咽癌中的效益。方法　收集 2 6 6例未经治疗的鼻咽癌患者和 347例健康成人的血清。用免疫酶法检测VCA IgA ,用酶联免疫吸附法 (ELISA)替代免疫酶法检测EA IgA和EA IgG抗体。应用新的统计学方法来评估这三项检测的不同优势比。结果　同时应用VCA IgA、EA IgG和EA IgA三项检测的灵敏度和特异度分别为 95 .11%和 97.4 1% ,高于这三项检测的单独应用 (VCA IgA为 90 .6 0 %和 94 .5 2 % ,EA IgG为93.98%和 93.6 6 ,EA IgA为 89.84 %和 88.18% )。再者 ,VCA IgA、EA IgG和EA IgA三项检测均呈阳性者的优势比 (1912 .5 )远远高于其中两项检测呈阳性者 (VCA IgA和EA IgG为 2 7.90 32 ;EA IgG和EA IgA为 11.16 90 ;VCA IgA和EA IgA为 8.0 32 8) ,而两项检测阳性的优势比又高于单个检测阳性者(VCA IgA为 0 .12 14 ;EA IgG为 0 .170 5 ;EA IgA为 0 .0 4 88)。结论　ELISA法较免疫酶法更能确切反映血清中EB病毒早期抗原的抗体水平。VCA IgA、EA IgG和EA IgA的联合应用能显著提高灵敏度和特异度 ,明显增高检测阳性的优势比 ,因此 ,能有效地提高EB病毒血清学在诊断鼻咽癌时的效益。Objective To investigate the efficiency of concurrent application of VCA IgA, EA IgA and EA IgG serological tests in diagnosing nasopharyngeal carcinoma (NPC). Methods The sera of 266 untreated NPC patients and 347 healthy adults were collected. In addition to the conventional immunoenzymatic method of VCA IgA test, enzyme l inked immunosorbent assay (ELISA) was adopted as an alternative to test the anti body level of EA IgG and EA IgA. A new statistical formula was used to evaluat e the odds ratio of different combinations of these three tests. Results The sensitivity and specificity of VCA IgA,EA IgG and EA IgA concurrently wer e as high as 95.11% and 97.41%, respectively, which were higher than those of s ingle test (90.60% and 94.52% for VCA IgA, 93.98% and 93.66% for EA IgG, 89.84 % and 88.18% for EA IgA). Furthermore, the odds ratio of 3 test positivity (1 912.5) was higher than those of 2 test positivity (27.903 2 for VCA IgA and EA IgG, 11.169 0 for EA IgG and EA IgA, 8.032 8 for VCA IgA and EA IgA), w hich were even higher than those of 1 test positivity (0.121 4 for VCA IgA, 0.170 5 for EA IgG and 0.048 8 for EA IgA). Conclusion ELISA is more accurate in reflecting the antibody level of EA IgG and EA IgA than the conventional immunoenzymatic method. The concurrent applica tion of VCA IgA, EA IgG and EA IgA test can markedly improve the sensitivity, specificity and odds ratio as well, thus resulting in enhancing the efficiency of diagnosing nasopharyngeal carcinoma serologically.

关 键 词：鼻咽肿瘤 诊断 EPSTEIN-BARR病毒 血清学 酶联免疫吸附测定 

分 类 号：R739.63[医药卫生—肿瘤]