四种EB病毒抗体联合检测在鼻咽癌筛查中的价值  

Screening value of combined detection of four EB virus antibodies in nasopharyngeal carcinoma

作　　者：邓日辉[1] 刘丽燕 谢伟柯[1] 刘明岭[1] 张桂荣 DENG Rihui;LIU Liyan;XIE Weike;LIU Mingling;ZHANG Guirong(The First Affiliated Hospital of Guangzhou University of TCM,Guangzhou,Guangdong,510405,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405 [2]上海芯超医学检验所,上海 [3]广州中医药大学第三附属医院,广东广州

出　　处：《中国中西医结合耳鼻咽喉科杂志》2022年第2期88-91,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的评价EB病毒抗体联合检测在鼻咽癌筛查中的临床价值。方法收集205例已确诊为鼻咽癌患者及108名健康体检者的血清,采用ELISA方法检测血清中EBV抗体VCA-IgA、EA-IgA、Rta-IgG、NA1-IgA含量。结果鼻咽癌组EBV抗体VCA-IgA、EA-IgA、Rta-IgG、NA1-IgA阳性检出率分别为70.73%、41.46%、44.39%、58.05%;对照组阳性检出率分别为12.96%、8.33%、7.41%、10.19%,鼻咽癌组阳性率显著高于健康对照组(P<0.01);EA-IgA、Rta-IgG、NA1-IgA在鼻咽癌Ⅲ期和Ⅳ期的阳性率显著高于鼻咽癌Ⅰ期、Ⅱ期的阳性率(P<0.01),VCA-IgA在鼻咽癌Ⅲ期和Ⅳ期阳性率显著高于鼻咽癌Ⅰ期的阳性率(P<0.01)。鼻咽癌Ⅰ期和Ⅱ期患者VCA-IgA的阳性率显著高于EA-IgA、Rta-IgG、NA1-IgA(P<0.05或P<0.01)。VCA-IgA、EA-IgA、Rta-IgG、NA1-IgA 4种抗体并联检测的灵敏度显著高于EBV抗体单项、任意2种或3种抗体并联检测(P<0.05或P<0.01);4种抗体联合检测的阴性预测值显著高于单项抗体检测(P<0.01);4种抗体串联检测的特异度(99.99%)高于并联检测的特异度(66.35%)。结论联合检测EBV抗体VCA-IgA、EA-IgA、Rta-IgG、NA1-IgA有相互补充作用,4种抗体并联检测敏感度最高,可提高鼻咽癌筛查的敏感度,串联检测时可提高鼻咽癌筛查的特异度。Objective To evaluate the screening value of combined detection of four EB virus antibodies in nasopharyngeal carcinoma.Methods The sera of 205 patients with nasopharyngeal carcinoma and 108 healthy people were collected.The contents of EBV antibodies VCA-IgA、EA-IgA、Rta-IgG and Na1-IgA were detected by ELISA.Results The positive rates of EBV antibodies VCA-IgA、EA-IgA、Rta-IgG and Na1-IgA in nasopharyngeal carcinoma group were 70.73%,41.46%,44.39%and 58.05%respectively.The positive rates in the control group were 12.96%,8.33%,7.41%and 10.19%respectively.The positive rate in the nasopharyngeal carcinoma group was significantly higher than that in the healthy control group(P<0.01).The positive rates of EA-IgA、Rta-IgG and Na1-IgA in stage III and IV of nasopharyngeal carcinoma were significantly higher than those in stage I and II of nasopharyngeal carcinoma(P<0.01),and the positive rates of VCA-IgA in stage III and IV of nasopharyngeal carcinoma were significantly higher than those in stage I of nasopharyngeal carcinoma(P<0.01).The positive rate of VCA-IgA in patients with stage I and stage II nasopharyngeal carcinoma was significantly higher than that of EA-IgA、Rta-IgG and Na1-IgA(P<0.05 or P<0.01).The sensitivity of parallel detection of VCA-IgA、EA-IgA、Rta-IgG and Na1-IgA was significantly higher than that of single EBV antibody,any two or three antibodies(P<0.05 or P<0.01).The negative predictive value of combined detection of four antibodies was significantly higher than that of single antibody(P<0.01).The specificity of series detection(99.99%)was higher than that of parallel detection(66.35%).Conclusion The combined detection of EBV antibodies VCA-IgA、EA-IgA、Rta-IgG and Na1-IgA can complement each other.The sensitivity of parallel detection of 4 antibodies was the highest,which can improve the sensitivity of nasopharyngeal carcinoma screening,and series detection can improve the specificity of nasopharyngeal carcinoma screening.

关 键 词：联合检测 EBV抗体 鼻咽癌 

分 类 号：R739.63[医药卫生—肿瘤]