血清颗粒溶素对鼻咽癌的诊断价值研究  

Diagnosis value of granulysin in patients with nasopharyngeal carcinoma

作　　者：高娟 彭裕萍 张昌明 柳林整[1] 申江江 GAO Juan;PENG Yuping;ZHANG Changming;LIU Linzheng;SHENG Jiangjiang(Department of Otolaryngology Head and Neck Surgery,Yulin First Hospital of Shanxi Province,Yulin 719000,China)

机构地区：[1]陕西省榆林市第一医院耳鼻咽喉头颈外科,719000 [2]第四军医大学第一附属医院西京医院耳鼻咽喉头颈外科

出　　处：《浙江医学》2018年第14期1599-1601,1605,共4页Zhejiang Medical Journal

摘　　要：目的探讨血清颗粒溶素水平检测对鼻咽癌(NPC)患者的诊断价值。方法选取NPC患者109例(NPC组),鼻咽炎(NPT)患者68例(NPT组),非NPC、非NPT体检者60例(对照组)为研究对象。观察并比较3组受检者血清NPC标志物[抗EB病毒衣壳免疫球蛋白A(EBV-VCA-IgA)、EB病毒核糖核酸(EBVDNA)]阳性率及GNLY水平;比较不同临床特征NPC患者血清GNLY水平;比较血清GNLY、VCA-IgA对鼻咽部病变患者NPC的诊断价值。结果 3组受检者血清NPC标志物阳性率、GNLY水平比较均有统计学差异(均P<0.05)。NPC组患者血清EBVDNA阳性率、EBV-VCA-IgA阳性率均高于NPT组与对照组(均P<0.05),血清GNLY水平低于NPT组与对照组(P<0.05)。NPT组患者血清EBV-VCA-IgA阳性率、血清GNLY水平均高于对照组(均P<0.05)。TNM分期IV期NPC患者血清GNLY水平明显高于I期、II期患者(均P<0.05),T3~T4期患者高于T_1~T_2期患者(P<0.05),N3期患者高于N0期患者(P<0.05)。血清GNLY水平对鼻咽部病变患者NPC的诊断价值高于EBV-VCA-IgA。以血清GNLY水平≤9.64 ng/ml为界时,血清GNLY水平对鼻咽部病变患者NPC的诊断灵敏度为0.852,特异度为0.797。结论 NPC患者血清GNLY水平异常降低,血清GNLY水平检测有助于判断鼻咽部的良恶性病变。Objective To examine the diagnosis value of granulysin(GNLY)in patients with nasopharyngeal carcinoma(NPC). Methods One-hundred and nine NPC patients,68 nasopharyngitis(NPT)patients and 60 healthy controls were enrolled in this study.The levels of EBV-DNA,VCA-IgA and GNLY were tested in three groups.The association between GNLY levels and clinical features of NPC patients was analyzed.The diagnosis value of GNLY and VCA-lgA for NPC was examined. Results There were significant differences in levels of EBV-DNA,VCA-IgA and GNLY among three groups(P<0.05).The positively rates of EBV DNA and VCA-IgA in NPC group were higher than those in NPT group and control group(P<0.05).The levels of GNLY in NPC group were lower than those in NPT group and control group(P<0.05).The positively rate of VCA-IgA and levels of GNLY in NPT group were higher than those in control group(P<0.05).The contents of GNLY in stage IV NPC patients were higher than those in stage I and II NPC patients(P<0.05).The T1-2 patients had a lower GNLY levels compared with T3-4 patients(P<0.05).N3 patients had a higher GNLY contents in comparison with those of N0 patients(P<0.05).ROC analysis suggested that the AUC of GNLY for distinguish NPT and NPC patients was higher than that of VCA-IgA.The cut-off value of GNLY for NPC diagnosis was≤9.64ng/ml with a sensitivity of 0.852 and specificity of 0.797. Conclusion The levels of GNLY are significantly reduced in NPC patients.GNLY may be useful to distinguish benign and malignant nasopharyngeal lesions.

关 键 词：颗粒溶素 鼻咽癌 诊断 

分 类 号：R739.63[医药卫生—肿瘤]