联合检测p53自身抗体与EB病毒VCA-IgA对鼻咽癌的诊断价值  

Combined analysis of autoantibodies against p53 and Epstein-Barr virus VCA-IgA for improved diagnosis of nasopharyngeal carcinoma

作　　者：彭裕辉[1] 谢长乐 庄珊珊[1] 张利群[3] 许镒洧[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院检验科,广东汕头515041 [2]开平市中心医院肿瘤外科,广东开平529300 [3]汕头大学医学院附属肿瘤医院信息科,广东汕头515041

出　　处：《癌变．畸变．突变》2015年第1期26-29,34,共5页Carcinogenesis,Teratogenesis & Mutagenesis

基　　金：广东省科技计划项目(2013B021800250);汕头市医疗科技计划项目(汕府科[2013]88号)

摘　　要：目的：VCA-Ig A（ELISA）检测242例鼻咽癌患者和218例正常对照者血清中p53自身抗体和EB病毒壳抗体（VCA-Ig A）的表达水平。结果：血清p53自身抗体的水平在鼻咽癌患者组明显高于正常对照组,差异有统计学意义（P〈0.01）。p53自身抗体和VCA-Ig A对鼻咽癌的诊断敏感度分别为40.1%（95%CI：33.9%~46.6%）和47.5%（95%CI：41.1%~54.0%）;特异度分别为95.0%（95%CI：90.9%~97.3%）和95.4%（95%CI：91.5%~97.7%）,两者联合检测的敏感度和特异度分别为69.4%（95%CI：63.1%~75.0%）和90.8%（95%CI：86.0%~94.2%）。p53自身抗体、VCA-Ig A和两者联合检测在早期鼻咽癌患者中的阳性表达均明显高于正常对照组（P均〈0.01）。p53自身抗体的阳性表达率与鼻咽癌患者的性别、年龄、T分期、N分期和总TNM分期之间均无明显相关性（P〉0.05）。结论：血清p53自身抗体作为一种潜在的诊断标志物,与VCA-Ig A联合检测可能有助于筛查和诊断鼻咽癌。OBJECTIVE：To evaluate the diagnostic value of serum autoantibodies against p53 in patients with nasopharyngeal carcinoma. METHODS：The study included 242 patients with NPC and 218 normal controls. Serum levels of autoantibodies against p53 and classical Epstein-Barr virus VCA-IgA were measured by Enzyme-linked immunosorbent assay （ELISA）.RESULTS：Serum levels of autoantibodies against p53 were significantly higher in NPC than in normal controls （P〈0.01）. Measurement of autoantibodies against p53 and VCA-IgA demonstrated a sensitivity/specificity of 40.1% （95%CI：33.9%-46.6%）/95.0% （95%CI：90.9%-97.3%） and 47.5% （95%CI：41.1%-54.0%）/95.4% （95%CI：91.5%-97.7%）,respectively. The combination of autoantibodies against p53 and VCA-IgA yielded an enhanced sensitivity of 69.4% （95%CI：63.1%-75.0%） and a similar specificity of 90.8% （95%CI：86.0%-94.2%）. Moreover,detection of autoantibodies against p53 could differentiate early stage NPC patients from normal controls. The positive rate of autoantibodies against p53 was not significantly related to age,gender,T stage,N stage or overall stage （P〉0.05）.CONCLUSION：Autoantibodies against p53 might be used as a potential biomarker supplementary to VCA-IgA for screening and diagnosis of NPC.

关 键 词：P53 自身抗体 EB病毒 VCA-IGA 鼻咽癌 诊断 

分 类 号：R730.4[医药卫生—肿瘤]