EB病毒四项抗体联合EB病毒DNA检测在鼻咽癌早期诊断中的应用价值  

Study on the value of EBV quadruple antibody combined with EBV-DNA test in the early diagnosis of nasopharyngeal carcinoma

作　　者：纪越 王志海[2] 张茏[1] Ji Yue;Wang Zhihai;Zhang Long(Department of Otolaryngology,Head and Neck Surgery,Yichang Central People’s Hospital,First College of Clinical Medical Science,China Three Gorges University,Hubei Yichang 443003,China;Department of Otolaryngology,Head and Neck Surgery,First Affiliated Hospital of Chongqing Medical University,Chongqing 400042,China)

机构地区：[1]三峡大学第一临床医学院(宜昌市中心人民医院)耳鼻咽喉头颈外科,湖北宜昌443003 [2]重庆医科大学附属第一医院耳鼻咽喉头颈外科,重庆400042

出　　处：《中国医刊》2023年第3期291-294,共4页Chinese Journal of Medicine

基　　金：国家自然科学基金青年科学基金(81902776)。

摘　　要：目的探究EB病毒(Epstein-Barr virus,EBV)四项抗体联合EBV-DNA检测在鼻咽癌(nasopharyngeal carcinoma,NPC)早期诊断中的临床应用价值。方法选取2021年1—12月三峡大学第一临床医学院(宜昌市中心人民医院)耳鼻咽喉头颈外科收治的鼻咽肿物患者71例,其中经鼻咽活检确诊为NPC的53例患者设为NPC组,确诊为非NPC的18例患者设为非NPC组,另选择同期健康体检者50例设为对照组。各组均行EBV四项抗体及EBV-DNA检测,分析联合检测对NPC的早期诊断价值。结果NPC组衣壳抗原(VCA)-IgM阳性率高于对照组(P<0.05);NPC组VCA-IgG、早期抗原(EA)-IgG、核抗原(NA)-IgG、EBV-DNA阳性率高于非NPC组及对照组(P<0.05)。随着肿瘤分期增高,NPC患者的EA-IgG、NA-IgG、EBV-DNA阳性率明显升高(P<0.05),Ⅱ期、Ⅲ期和Ⅳ期患者的EA-IgG、EBV-DNA阳性率明显高于Ⅰ期患者(P<0.05)。EBV四项抗体与DNA联合检测诊断NPC的敏感度(96.23%)及阴性预测值(85.71%)均高于单独检测(P<0.05)。结论EBV四项抗体联合EBV-DNA检测可用于NPC的早期诊断,具有较高的临床应用价值。Objective To investigate the value of EBV quadruple antibody combined with EBV-DNA test in the early diagnosis of nasopharyngeal carcinoma(NPC).Method Seventy-one patients with nasopharyngeal swelling admitted to Yichang Central People’s Hospital,First College of Clinical Medical Science,China Three Gorges University from January to December 2021 were selected.53 patients with NPC confirmed by nasopharyngeal biopsy were set up as the NPC group,18 patients with non-NPC were set up as the nonNPC group,and another 50 patients with healthy physical examination at the same period were selected as the control group.The three groups were tested for the four EBV antibodies and EBV DNA,and the value of the combined test for the early diagnosis of NPC was analyzed.Result The positive rate of VCA-IgM in the NPC group was higher than that in the control group(P<0.05);the positive rates of VCA-IgG,EA-IgG,NA-IgG and EBV-DNA in the NPC group were all higher than those in the non-NPC group and the control group(P<0.05).The positive rates of EA-IgG,NA-IgG and EBV-DNA in patients with nasopharyngeal carcinoma increased significantly with the severity of tumour stage(P<0.05);the positive rates of EA-IgG and EBV-DNA in stageⅠpatients were lower than those in stageⅡ,ⅢandⅣpatients(P<0.05).The sensitivity(96.23%)and negative predictive value(P<0.05)of the combined test for the four EBV antibodies and DNA for the diagnosis of nasopharyngeal carcinoma were higher than those of the control group.53 and the highest negative predictive value(85.71%)(P<0.05).Conclusion EBV quadruple antibody combined with EBV DNA testing is of high value in the early diagnosis of nasopharyngeal carcinoma and can,to a certain extent,assess the condition of patients with nasopharyngeal carcinoma.

关 键 词：鼻咽癌 EB病毒抗体 EB病毒DNA 诊断 

分 类 号：R739.6[医药卫生—肿瘤]