EBV感染与鼻咽癌病情进展的关系及其相关抗体的诊断价值  

Relationship between EBV infection and the progression of nasopharyngeal carcinoma and the diagnostic value of its associated antibodies

作　　者：黄寅 熊健 蔡轶伦 何花 黄婷婷 林凌[4] HUANG Yin;XIONG Jian;CAI Yi-lun;HE Hua;HUANG Ting-ting;LIN Ling(Wuhan University of Technology Hospital,Wuhan,Hubei 430070,China;不详)

机构地区：[1]武汉理工大学医院耳鼻喉科,湖北武汉430070 [2]武汉市东西湖区人民医院耳鼻咽喉科,湖北武汉430040 [3]武汉理工大学医院外科,湖北武汉430070 [4]武汉市中心医院耳鼻喉头颈外科,湖北武汉430014

出　　处：《中华医院感染学杂志》2024年第4期547-551,共5页Chinese Journal of Nosocomiology

基　　金：湖北省自然科学基金资助项目(WJ2019Q037);武汉市卫健委基金资助项目(WX21Q51)。

摘　　要：目的探讨EB病毒(EBV)感染与鼻咽癌病情进展及其相关抗体的诊断价值.方法选择2021年1月—2023年3月武汉理工大学医院收治的鼻咽癌患者103例作为鼻咽癌组,另选112名同期收治的健康体检者的临床资料作为对照组;比较两组血清EBV-DNA及早期抗原-免疫球蛋白A抗体(EA-IgA)、衣壳抗原(VCA)-IgA、Rta蛋白(Rta)-IgG水平,绘制受试者工作特征(ROC)曲线,分析血清EBV-DNA及EA-IgA、VCA-IgA、Rta-IgG对鼻咽癌的诊断价值,并用多因素Logistic归纳鼻咽癌发生的危险因素.结果鼻咽癌组血清EBV-DNA及EA-IgA、VCA-IgA、Rta-IgG高于对照组(P<0.05);Ⅲ~Ⅳ期组血清EBV-DNA及EA-IgA、VCA-IgA、Rta-IgG高于Ⅰ~Ⅱ期组(P<0.05);血清EBV-DNA及EA-IgA、VCA-IgA、Rta-IgG联合诊断鼻咽癌的曲线下面积(AUC)值为0.929,高于血清EBV-DNA及EA-IgA、VCA-IgA、Rta-IgG单独检测(0.866、0.849、0.832、0.856,P<0.05).多因素Logistic回归分析结果显示,EBV-DNA、EA-IgA、VCA-IgA、Rta-IgG是鼻咽癌发生的危险因素(OR=4.768、2.596、3.013、2.992,P均<0.05).结论鼻咽癌的发生与血清EBV-DNA及EA-IgA、VCA-IgA、Rta-IgG有关,四者均可参与病情进展过程,且四者联合检测对鼻咽癌的诊断价值更高.OBJECTIVE To investigate the relationship between EB virus(EBV)infection and the progression of nasopharyngeal carcinoma and the diagnostic value of its associated antibodies.METHODS Totally 103 patients with nasopharyngeal carcinoma admitted to Wuhan University of Technology Hospital from Jan.2021 to Mar.2023 were selected as the nasopharyngeal carcinoma group,and 112 healthy individuals underwent physical exami-nation during the same period were selected as the control group;the levels of serum EBV-DNA,early antigen immunoglobulin A antibody(EA IgA),capsid antigen(VCA)IgA,and Rta protein(Rta)IgG between two groups were compared,the diagnostic value of serum EBV-DNA,EA IgA,VCA IgA,and Rta IgG for nasopha-ryngeal carcinoma was analyzed by plotting the receiver operating characteristic(ROC)curve,and the risk factors for the occurrence of nasopharyngeal carcinoma were summarized by multivariate Logistic regression.RESULTS The serum levels of EBV-DNA,EA-IgA,VCA-IgA,and Rta-IgG in the nasopharyngeal carcinoma group were higher than those in the control group(P<0.05).The serum levels of EBV-DNA,EA-IgA,VCA-IgA,and Rta-IgG in the stage Ⅲ-Ⅳ group were higher than those in the stage Ⅰ-Ⅱ group(P<0.05).The area under the curve(AUC)value for the combined diagnosis of nasopharyngeal carcinoma by serum EBV-DNA,EA-IgA,VCA-IgA,and Rta-IgG was 0.929,which was higher than that of EBV-DNA with EA-IgA,VCA-IgA,and Rta-IgG alone(0.866,0.849,0.832,0.856,P<0.05).The results of multivariate Logistic regression analysis showed that EBV-DNA,EA IgA,VCA IgA,and Rta IgG were independent risk factors for the occurrence of na-sopharyngeal carcinoma(OR=4.768,2.596,3.013,2.992,all P<0.05).CONCLUSION The occurrence of na-sopharyngeal carcinoma was associated with serum levels of EBV-DNA,EA-IgA,VCA-IgA,and Rta-IgG,all four could be involved in the progress of the patient's condition,and the combined detection of the four had higher diagnostic value for nasopharyngeal carcinoma.

关 键 词：鼻咽癌 EB病毒 感染 抗体 病情进展 诊断价值 

分 类 号：R739.6[医药卫生—肿瘤]