基于5种EB病毒抗体评估广州地区人群患鼻咽癌的危险度  

An applied study on assessing the risk of nasopharyngeal carcinoma in Guangzhou population based on 5 kinds of EBV antibodies

作　　者：周勇 陈浩[2] 窦前 李玥 刘沃峰 ZHOU Yong;CHEN Hao;DOU Qian;LI Yue;LIU Wofeng(Guangzhou Cadre Health Management Center,Guangzhou 510530,China;不详)

机构地区：[1]广州市干部健康管理中心,广州510530 [2]中山大学肿瘤防治中心,广州510060

出　　处：《实用医学杂志》2023年第5期602-606,612,共6页The Journal of Practical Medicine

基　　金：广东省自然科学基金项目(编号:2018A030313622);广州市科技计划项目(编号:201904010153)。

摘　　要：目的 分析广州地区正常体检人群与该地区鼻咽癌患者的5种EB病毒抗体谱,并尝试建立一种简单、高效和实用性强的血清学筛查方法,适合为该地区健康人群进行鼻咽癌筛查。方法 选择收集2018—2019年在中山大学肿瘤防治中心门诊首诊鼻咽癌病例及在广州市干部健康管理中心体检中发现的首发鼻咽癌病例共204例的血清,健康组为2019年12月至2020年11月在广州市干部健康管理中心体检的健康人群共2 829例。通过分析5种EB病毒抗体谱在鼻咽癌患者组和正常组之间的差异,并通过logistic回归分析建立血清指标预测鼻咽癌的统计模型。结果 VCA/IgA、NA1/IgA、Rta/IgG、EA/IgA和EA/IgG用于诊断鼻咽癌的最佳截断值分别是1.19、0.31、0.33、0.62、0.83,5种抗体阳性率在疾病与对照组内,各年龄组阳性率差异无统计学意义(P>0.05)。两种联合预测鼻咽癌患病模型预测一致率分别为96.5%、96.2%,两者的阴性预测值均> 98%。结论 VCA/IgA+NA1/IgA与NA1/IgA+Rta/IgG这两种联合检测预测鼻咽癌具有较好的敏感度和特异度,预测的模型对非鼻咽癌的正确判断准确率在98.8%以上,是一种实用性很强,比较准确的筛查方法。Objective To study the five EB virus antibody profiles in normal physical examination people and nasopharyngeal carcinoma(NPC)patients in Guangzhou,we try to establish a simple,efficient and practical serological screening method,which is suitable for NPC screening in the region.Methods A total of 204 serum samples of the patients with NPC were collected.A total of 2,829 healthy people′s serum samples were collected in Guangzhou cadre Health Management center from December 2019 to November 2020,and the male⁃female ratio was close to 3∶1.The antibody profiles and the differences of five kinds of EB virus antibody expression between two groups were analyzed,a predictive model for NPC by serological indicators was established through Logistic regression analysis.Results The optimal cut⁃off values of VCA/IgA,NA1/IgA,Rta/IgG,EA/IgA and EA/IgG for the diagnosis of NPC were 1.19,0.31,0.33,0.62 and 0.83,respectively.The AUC was 0.948,0.916,0.951,0.873 and 0.942,respectively.There was no significant difference in the positive rates of five antibodies between the disease group and the control group(P>0.05).The predictive coincidence rates of the two combined predictive models for NPC were 96.5%and 96.2%respectively,and the negative predictive values of both models were greater than 98%.Conclusion The combined detection model of VCA/IgA+NA1/IgA and NA1/IgA+Rta/IgG have good sensitivity and specificity in predicting NPC all.The accuracy of the prediction model in determining non⁃nasopha⁃ryngeal carcinoma in physical examination population in this area is more than 98.8%.

关 键 词：鼻咽癌 EB病毒抗体 患病预测模型 肿瘤筛查 

分 类 号：R739.63[医药卫生—肿瘤]