血清EBV抗体及其DNA联合检测对鼻咽癌诊断价值  

VALUE OF COMBINED MEASUREMENT OF SERUM EPSTEIN-BARR VIRUS ANTIBODIES AND EPSTEIN-BARR VIRUS DNA IN THE DIAGNOSIS OF NASOPHARYNGEAL CARCINOMA

作　　者：秦倪 王帅[2] 刘雯 QIN Ni;WANG Shuai;LIU Wen(School of Basic Medicine,Qingdao University Medical College,Qingdao 266071,China)

机构地区：[1]青岛大学医学部基础医学院,山东青岛266071 [2]青岛大学附属青岛市妇女儿童医院检验科

出　　处：《青岛大学学报（医学版）》2023年第1期64-67,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省自然科学基金项目(ZR2017BH106)。

摘　　要：目的探讨血清EB病毒(EBV)抗体以及EBV-DNA联合检测在鼻咽癌治疗前诊断中的临床价值。方法采用酶联免疫吸附试验(ELISA)法检测163例鼻咽癌病人和140例健康对照者血清EBV衣壳抗原IgA(VCA-IgA)、早期抗原IgA(EA-IgA)、Rta蛋白IgG(Rta-IgG)抗体水平,荧光定量聚合酶链式反应法检测EBV-DNA载量,评价各项指标在鼻咽癌诊断中的价值。结果鼻咽癌病人血清EBV VCA-IgA、EA-IgA、Rta-IgG抗体效价和EBV-DNA载量水平以及其阳性率均显著高于健康对照者(t=12.499~14.597,Z=12.893,χ^(2)=51.274~153.132,P<0.05)。VCA-IgA+EA-IgA+Rta-IgG+EBV-DNA联合检测诊断鼻咽癌的曲线下面积(AUC)为0.992。Ⅲ~Ⅳ期鼻咽癌病人VCA-IgA、Rta-IgG抗体效价及EBV-DNA载量均显著高于Ⅰ~Ⅱ期病人(t=3.332、4.324,Z=10.507,P<0.05)。结论VCA-IgA+EA-IgA+Rta-IgG+EBV-DNA联合检测对于鼻咽癌早期筛查及诊断具有较高的临床价值。Objective To investigate the clinical value of combined measurement of serum Epstein-Barr virus(EBV)antibodies and EBV-DNA in the preoperative diagnosis of nasopharyngeal carcinoma.Methods A total of 163 patients with nasopharyngeal carcinoma and 140 healthy controls were enrolled.ELISA was used to measure the serum levels of VCA-IgA,EA-IgA,and Rta-IgG,and quantitative real-time PCR was used to measure EBV-DNA load.The value of each indicator in the diagnosis of nasopharyngeal carcinoma was analyzed.Results Compared with the healthy controls,the patients with nasopharyngeal carcinoma had significantly higher titers of VCA-IgA,EA-IgA,and Rta-IgG antibodies and significantly higher load and positive rate of EBV-DNA(t=12.499-14.597,Z=12.893,χ^(2)=51.274-153.132,P<0.05).Combined measurement of VCA-IgA+EA-IgA+Rta-IgG+EBV-DNA had an area under the ROC curve of 0.992 in the diagnosis of nasopharyngeal carcinoma.The patients with stageⅢ-Ⅳnasopharyngeal carcinoma had significantly higher titers of VCA-IgA and Rta-IgG antibodies and EBV-DNA load than those with stageⅠ-Ⅱnasopharyngeal carcinoma(t=3.332,4.324,Z=10.507,P<0.05).Conclusion Combined measurement of VCA-IgA+EA-IgA+Rta-IgG+EBV-DNA has a high clinical value in the early screening and diagnosis of nasopharyngeal carcinoma.

关 键 词：鼻咽癌 疱疹病毒4型 人 抗体 病毒 DNA 病毒 诊断 

分 类 号：R739.63[医药卫生—肿瘤]