鼻咽癌筛查中三种EB病毒抗体检测的应用价值分析  

Analysis of the application value of three EB virus antibodies in the screening of nasopharyngeal carcinoma

作　　者：付丽 李延忠[2] FU Li;LI Yan-zhong(Department of ENT,Central Hospital of Shandong Electric Power,Shandong Jinan,250000,China;Qilu Hospital of Shandong University,Shandong Jinan,250000,China)

机构地区：[1]山东电力中心医院耳鼻喉科,山东济南250000 [2]山东大学齐鲁医院,山东济南250000

出　　处：《临床医药文献电子杂志》2017年第84期16450-16453,共4页Electronic Journal of Clinical Medical Literature

摘　　要：目的比较检测Rta蛋白IgG抗体(Rta/IgG)、EBV早期抗原(EBV-EA)及EB病毒壳抗原(VCA)免疫球蛋白A抗体(IgA)用于筛查鼻咽癌的临床价值。方法选取2013年1月~2017年1月齐鲁医院门诊收治的鼻咽癌患者14例,尚未接受治疗,设为鼻咽癌组;选取同期于我院门诊就诊的非鼻咽癌但表现出鼻咽部症状的患者320例,设为非鼻咽癌组;选取同期于我院体检的健康人500例设为健康组,采集3组研究对象空腹静脉血,应用酶联吸附试验ELISA检测血清中EB病毒Rta/IgG抗体、EA/IgA抗体及VCA/IgA抗体。结果鼻咽癌组Rta/IgG、EA/IgA及VCA/IgA抗体检测阳性率均明显高于非鼻咽癌组与健康组;非鼻咽癌组VCA/IgA抗体检测阳性率明显高于健康组;鼻咽癌组内VCA/IgA抗体检测阳性率明显高于EA/IgA与Rta/IgG抗体;非鼻咽癌组EA/IgA检测阳性率明显低于Rta/IgG、VCA/IgA;健康组EA/IgA检测阳性率低于Rta/IgG与VCA/IgA,比较均有显著性差异(P<0.05);VCA/IgA抗体检测灵敏度明显高于EA/IgA、Rta/IgG,Rta/IgG也高于EA/IgA;EA/IgA抗体特异度与阳性预测值明显高于Rta/IgG、VCA/IgA,比较均有显著性差异(P<0.05)。结论综上所述,Rta准确度、灵敏度及特异度均较高,VCA灵敏度、特异度较高,EA特异度高但灵敏度较低,相比而言VCA、Rta筛查NCP临床价值较高,可结合实际选择联合检测法,避免漏诊。Objective To compare the clinical value of Rta protein IgG antibody(Rta/IgG),EBV early antigen(EBV-EA)and Epstein-Barr virus shell antigen(VCA)immunoglobulin A antibody(IgA)for screening nasopharyngeal carcinoma.Methods 14 patients with nasopharyngeal carcinoma admitted in Qilu Hospital clinic from January 2013 to January 2017 were enrolled in the Department of Otolaryngology,and the patients were not treated with nasopharyngeal carcinoma.The non-nasopharyngeal carcinoma The patients with nasopharyngeal symptoms were treated with non-nasopharyngeal carcinoma group.500 healthy subjects were selected as healthy group.Three groups of subjects were collected with fasting venous blood.ELISA was performed by enzyme-linked immunosorbent assay(ELISA)EB virus Rta/IgG antibody,EA/IgA antibody and VCA/IgA antibody.Results The positive rate of Rta/IgG,EA/IgA and VCA/IgA in nasopharyngeal carcinoma group was significantly higher than that in non-nasopharyngeal carcinoma group and healthy group.The positive rate of VCA/IgA antibody in non-nasopharyngeal carcinoma group was significantly higher than that in healthy group The positive rate of VCA/IgA in nasopharyngeal carcinoma group was significantly higher than that in EA/IgA and Rta/IgG antibody.The positive rate of EA/IgA in non-nasopharyngeal carcinoma group was significantly lower than that in Rata/IgG and VCA/IgA(P<0.05).The sensitivity of VCA/IgA antibody was significantly higher than that of EA/IgA,Rta/IgG and Rta/IgG,and the sensitivity of VCA/IgA was higher than that of Rat/IgG and VCA/IgA EA/IgA;EA/IgA antibody specificity and positive predictive value were significantly higher than Rta/IgG,VCA/IgA,were significantly different(P<0.05).Conclusion In addition,the accuracy,sensitivity and specificity of RTA were higher,VCA sensitivity,specificity were higher,EA specificity was higher but the sensitivity was lower,compared with VCA,Rta screening NCP clinical value is higher,Can be combined with the actual selection of joint detection method to avoid missed diagnosis.

关 键 词：Rta蛋白IgG抗体 EBV早期抗原 EB病毒壳抗原 免疫球蛋白A抗体 鼻咽癌 

分 类 号：R739.63[医药卫生—肿瘤]