Bmi-1自身抗体与EB病毒衣壳抗原IgA抗体联合检测诊断鼻咽癌的价值  

Value of joint detection of Bmi-1 autoantibody and EB virus capsid antigen-immunoglobulin A antibody to the diagnosis of nasopharyngeal carcinoma

作　　者：许镒洧[1] 谢秀连[2] 翟田田[3] 方裕森[1] 彭裕辉[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]开平市中心医院内科,广东开平529300 [3]汕头大学医学院附属肿瘤医院放疗科,广东汕头515041

出　　处：《中华实用诊断与治疗杂志》2015年第8期812-814,共3页Journal of Chinese Practical Diagnosis and Therapy

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：目的探讨联合检测Bmi-1自身抗体与EB病毒衣壳抗原(viral capsid antigen,VCA)-IgA抗体在鼻咽癌诊断中的意义。方法鼻咽癌患者200例为鼻咽癌组,其中Ⅰ+Ⅱ期33例,Ⅲ+Ⅳ期167例,同期体检健康者216例为对照组,采用ELISA法检测血清Bmi-1自身抗体和EB病毒VCA-IgA表达情况,比较Bmi-1自身抗体、VCA-IgA、Bmi-1自身抗体+VCA-IgA阳性率,分析Bmi-1自身抗体、VCA-IgA单独及联合诊断鼻咽癌的效能。结果鼻咽癌Ⅰ+Ⅱ期、Ⅲ+Ⅳ期Bmi-1自身抗体阳性率(27.3%、30.5%)、VCA-IgA阳性率(33.3%、51.5%)、Bmi-1自身抗体+VCA-IgA阳性率(51.5%、65.3%)均高于对照组(5.6%、4.6%、9.3%)(P<0.05);Bmi-1自身抗体、VCA-IgA、Bmi-1自身抗体+VCA-IgA阳性率在性别、年龄、T分期、N分期和临床分期上差异无统计学意义(P>0.05);Bmi-1自身抗体诊断鼻咽癌的敏感性、特异性、阳性预测值、阴性预测值分别为30.0%、94.4%、83.3%、59.3%,VCA-IgA分别为49.0%、95.4%、90.7%、66.9%,Bmi-1自身抗体+VCA-IgA分别为63.0%、90.7%、86.3%、72.6%,联合检测诊断鼻咽癌的敏感性高于Bmi-1自身抗体、VCA-IgA单独检测(P<0.05)。结论血清Bmi-1自身抗体及VCA-IgA在鼻咽癌尤其是早期鼻咽癌诊断中有较高价值,二者联合检测可提高鼻咽癌的诊断效能。Objective To evaluate the value of joint detection of serum Bmi-1 autoantibody and EB virus capsid antigen- immunoglobulin A （VCA-IgA） antibody to the diagnosis of nasopharyngeal carcinoma （NPC）. Methods ELISA technique was used to detect the expressions of Bmi-1 autoantibody and EB VCAqgA antibody in 200 patients with NPC including 33 patients in stagesⅠ＋Ⅱ（stage Ⅰ＋Ⅱ group） and 167 in stage Ⅲ ＋ Ⅳ （stage Ⅲ ＋ Ⅳ group）, and 216 normal controls （control group）. The positive rates of Bmi-1 autoantibody, VCA-IgA antibody and joint detection of Bmi- 1 autoantibody and VCA-IgA antibody were compared to analyze their diagnostic efficiencies. Results The positive rates of Bmi-1 autoantibody （27. 3%, 30. 5%）, VCA-IgA antibody （33. 3%, 51. 5%） and joint detection of Bmi 1 autoantibody and VCA-IgA antibody （51.5 %, 65. 3%） were all significantly higher in stage Ⅰ＋Ⅱ group and stage Ⅲ ＋ Ⅳ group than those in control group （5.6%, 4.6%, 9.3%） （P∽O. 05）. Bmi-1 autoantibody, VCA-IgA antibody and joint detection of Bmi-1 autoantibody and VCA-IgA antibody showed no significant differences in the age, gender, T- stage, N-stage and clinical stage （P〉0. 05）. The sensitivity, specificity, positive predictive value and negative predictive value of Bmi-1 autoantibody for NPC were 30.0%, 94.4%, 83.3% and 59.3%, of VCA-IgA antibody were 49.0%, 95.4%, 90.7% and 66.9%, and of Bmi-1 autoantibody＋VCA-IgA antibody were 63.0%, 90.7%, 86.3% and 72.6%, respectively. The joint detection of Bmi-1 autoantibody and VCA-IgA antibody had a higher sensitivity for NPC than single detection of Bmi-1 autoantibody or VCA-IgA antibody （P〈0.05）. Conclusion Both Bmi-1 autoantibody and VCA-IgA antibody have higher values to the diagnosis of NPC, and the joint detection of them can improve the diagnostic efficiency of NPC.

关 键 词：鼻咽癌 Bmi-1自身抗体 EB病毒壳抗原IgA抗体 

分 类 号：R739.63[医药卫生—肿瘤] R730.43[医药卫生—临床医学]