HSP70自身抗体和EB病毒VCA-IgA联合检测对鼻咽癌诊断价值的探讨  

Combination of autoantibodies against HSP70 and viral capsid antigen immunoglobulin A for improved detection of nasopharyngeal carcinoma

作　　者：彭裕辉[1] 陈伟正[2] 黄利生[3] 方裕森[1] 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]汕头大学医学院附属肿瘤医院头颈外科,广东汕头515041 [3]汕头大学医学院附属肿瘤医院放疗科,广东汕头515041

出　　处：《中华肿瘤防治杂志》2015年第15期1198-1201,1206,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：广东省科技计划(2013B021800250);汕头大学医学院临床研究提升计划(201428)

摘　　要：目的探讨热休克蛋白（heat shock protein，HsP）70自身抗体和EB病毒衣壳抗原（viral capsidantigen，VCA）-IgA抗体联合检测对鼻咽癌（nasopharyngeal carcinoma，NPC）的诊断意义。方法收集2012—05-03—2014—04—22汕头大学医学院附属肿瘤医院收治的209例NPC患者和216名正常对照，采用酶联免疫吸附实验（enzyme-linked immunosorbentassay，EuSA）检测血清中HSP70自身抗体和EB病毒VCA-IgA的表达水平。结果NPC患者血清HSP70自身抗体的表达水平明显高于正常对照，P〈0．001。HSP70自身抗体对NPC的诊断敏感度为28．7％，95％CI为22．8～35．4；VCA-IgA为49．3％，95％CI为42．3～56．2。HSP70自身抗体诊断的特异度为94．9％，95％CI为90．8～97．3；VCA-IgA为95．8％，95％CI为92．0～98．0。两者联合检测的敏感度为63．2％，95％CI为56．2～69．6；特异度为91．2％，95％CI为86．4～94．5。两者联合检测的阳性率在早期NPC患者为53．1％（95％CI为35．0h70．5），高于正常对照的8．8％（95％CI为5．5～13．6），P〈0．001。HSP70自身抗体的阳性率与NPC患者的性别相关，P〈0．05；而与患者年龄、T分期、N分期和总TNM分期无关，P〉0．05。结论血清HSP70自身抗体对NPC具有潜在的诊断价值，与VCA-IgA联合检测可能有助于提高NPC的早期诊断率。OBJECTIVE To evaluate the diagnostic value of combined detection of serum autoantibodies against HSP70 and Epstein-Barr virus VCA-IgA in patients with nasopharyngeal carcinoma. METHODS The study included 209 patients with NPC and 216 normal controls from the Cancer Hospital of Shantou University Medical College between May 3rd, 2012 and April 22nd,2014. Serum levels of autoantibodies against HSP70 and VCA-IgA were measured by enzyme- linked immunosorbent assay （ELISA）. RESULTS The serum levels of autoantibodies against HSP70 were significantly higher in NPC than that in normal controls （P〈0. 001）. Measurement of autoantibodies against HSP70 and VCA-IgA demonstrated that sensitivity and specificity were 28.7M（95%CI：22.8--35.4） and 94. 9% （95%CI：90. 8--97.3）, and 49.3%（95 % CI ： 42.3 -- 56.2） and 95.8% （95% CI ： 92.0-- 98.0）, respectively. The combination of autoantibodies against HSP70 and VCA-IgA yielded an enhanced sensitivity of 63.2% （95% CI：56.2--69.6） and a specificity of 91.2% （95 %CI： 86.4-- 94.5）. The positive rate of this combined analysis in NPC patients [ 53. 1%（ 95% CI： 35.0 -- 70. 5） ] was higher than that in normal controls [8.8 % （95 %CI： 5.5--13.6）, P〈0. 001]. The positive rate of autoantibodies against HSP70 was related to gender （P〈0.05） ,but not significantly related to age,T stage,N stage or overall stage （P〈0.05）. CON- CLUSIONS Autoantibodies against HSP70 has potential diagnostic value for NPC. The combination of HSP70 autoantibody and VCA-IgA may help to improve the early diagnosis of NPC.

关 键 词：热休克蛋白70 自身抗体 EB病毒壳抗体 鼻咽癌 诊断 

分 类 号：R739.63[医药卫生—肿瘤]