EB病毒衣壳抗原抗体、早期抗原抗体、EB病毒DNA检测对鼻咽癌的诊断、预后评估价值  

Diagnosis and prognosis value of EB virus capsid antigen antibody,early antigen antibody,EB-DNA detection on nasopharyngeal carcinoma patients

作　　者：李琴[1] 谢琼[1] 

机构地区：[1]荆州市中心医院华中科技大学同济医学院附属荆州医院耳鼻喉科,湖北荆州434020

出　　处：《临床和实验医学杂志》2017年第4期359-363,共5页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨EB病毒衣壳抗原抗体(VAC-IgA)、早期抗原抗体(EA-IgA)、EB病毒DNA(EB-DNA)检测对鼻咽癌的诊断、预后评估价值。方法选择2011年2月至2012年2月医院收治的137例疑似鼻咽癌患者临床资料,采用酶联免疫吸附试验检测患者血清VAC-IgA、EA-IgA抗体滴度,PCR检测血浆EB-DNA拷贝数,并以最终临床病理检查结果作为"金标准",评价VAC-IgA、EA-IgA、EB-DNA检测对鼻咽癌的诊断效率。对确诊为鼻咽癌的患者行根治性放疗,患者随访3年,比较VAC-IgA、EA-IgA、EB-DNA不同表达组患者生存情况。结果 137例患者最终临床确诊为鼻咽癌95例,鼻咽癌确诊率为69.3%,以最终临床病理检查结果作为"金标准",VAC-IgA阳性检出率为37.2%(51/137),EA-IgA阳性检出率为63.5%(87/137),EB-DNA阳性检出率为27.7%(38/137);三者联合检测的特异度为85.7%(36/42),灵敏度为80.0%(76/95),准确度为81.8%(112/137),阳性预测值为92.7%(76/82),阴性预测值为65.5%(36/55),均高于VAC-IgA、EA-IgA、EB-DNA单项检测。VAC-IgA阴性组中位生存期23个月,显著高于VAC-IgA阳性组(17个月)(χ~2=6.117,P=0.045);EA-IgA阴性组中位生存期26个月,显著高于VAC-IgA阳性组(16个月)(χ~2=9.301,P=0.007);EB-DNA阴性组中位生存期24个月,显著高于EB-DNA阳性组(17个月),两组间比较差异具有统计学意义(χ~2=6.860,P=0.031)。结论病理检查是鼻咽癌诊断的"金标准",VAC-IgA、EA-IgA、EB-DNA三者联合检查能够为鼻咽癌的诊断提供一定参考,但不能作为确诊依据;VAC-IgA、EA-IgA、EB-DNA水平能够作为评估患者生存预后的指标之一。Objective To explore the diagnosis and prognosis value of EB virus capsid antigen antibody,early antigen antibody,EB-DNA detection on nasopharyngeal carcinoma patients. Methods 137 suspected nasopharyngeal carcinoma patients treated in hospital from February 2011 to February 2012 were selected,the serum VAC- IgA and EA- IgA antibody titers was detected by enzyme linked immunosorbent assay method,and plasma copy number of EB- DNA was detected by PCR method,the final clinical pathological examination results as ＂ gold standard＂,evaluated diagnostic efficiency of VAC- IgA,EA- IgA,EB- DNA detection on NPC. Radical radiotherapy was performed on patients diagnosed with NPC,and all patients were followed up for 3 years,compared the survival status of VAC- IgA,EA- IgA,and EB- DNA in different expression groups. Results 137 patients with the final clinical diagnosis of 95 cases of NPC,and NPC diagnosis rate was 69. 3%,with the final clinical pathological examination results as the ＂ gold standard＂,VAC- IgA positive rate was 37. 2%（ 51 /137）,EA- IgA positive rate was63. 5%（ 87 /137）,EB- DNA positive rate was 27. 7%（ 38 /137）. The specificity of combined detection was 85. 7%（ 36 /42）,the sensitivity was 80. 0%（ 76 /95）,the accuracy was 81. 8%（ 112 /137）,the positive predictive value for 92. 7%（ 76 /82） and the negative predictive value was 65. 5%（ 36 /55）,all were higher than those of the VAC- IgA,EA- IgA EB- DNA single detection. The median survival time of VAC-IgA negative group was 23 months,which was significantly higher than that of VAC- IgA positive group（ 17 months）（ χ2 =6. 117,P = 0. 045）.EA- IgA negative group median survival time was 26 months,significantly higher than that of VAC- IgA positive group（ 16 months）（ χ2= 9.301,P = 0. 007）. EB- DNA negative group median survival period of 24 months,which was significantly higher than that of the EB- DNA positive group（ 17 months）,the difference between the two groups were statistical significant（ χ2 =6. 8

关 键 词：鼻咽癌 衣壳抗原 早期抗原 EB病毒 诊断 预后 

分 类 号：R739.63[医药卫生—肿瘤]