EB病毒不同抗原IgA抗体检测在鼻咽癌诊断中的作用

目的探讨EB病毒壳抗原（VCA）、早期抗原（EA）和核抗原潜伏蛋白（EBNA1）免疫球蛋白A抗体（IgA）的检测对鼻咽癌血清学诊断的意义。方法应用免疫酶法（IE）和酶联吸附试验（ELISA）检测326例鼻咽癌患者、1290例非鼻咽癌门诊患者、职工体检767例血清中EB病毒VCA／IgA、EA／IgA、NA1／IgA抗体。结果鼻咽癌患者VCA／IgA、EA／IgA、EBNA1／IgA抗体阳性率分别为97．9％、8t．9％、和87．7％；非鼻咽癌患者组为18．0％、0．2％、和15．3％；对照组为5．1％、0、13．8％。鼻咽癌组的三种IgA抗体阳性率均分别高于非鼻咽癌组和对照组（P〈0．001），非鼻咽癌组的VCA／IgA抗体阳性率亦高于对照组（P〈0．001）。检测VCA／IgA的灵敏度和特异度为97．9％和94．9％；EA／IgA为引．9％和100％；EBNAI／IgA为87．7％和86．2％。结论VCA灵敏度和特异度都在较高的水平；EA灵敏度低特异度高；EBNA1灵敏度和特异度不及VCA，提示免疫酶法检测VCA／IgA抗体仍然是鼻咽癌血清学诊断中理想的方法，ELISA法EBNAI／IgA检测灵敏度和特异度比前者低有待进一步改进。

Detections of immunoglobulin A antibodies against different Epstein - Barr virus antigens in diagnosis of nasopharyn- geal carcinoma diagnosis

Objective To investigate the significance of detections of immunoglobulin （Ig） A antibodies against Epstein - Barr virus （EBV） viral capsid antigen （ VCA）, early antigens （EA） and nuclear antigen - 1 （ EBNAI ） in nasopharyngeal carcinoma （NPC） diagnosis. Methods Serum samples derived from 326 patients with NPC, 1209 non - NPC outpatients and 767 healthy controls were examined for the presence of VCA/IgA and EA/IgA by immunoenzymatic assay （IE）, EBNA1/IgA by enzyme - linked immnunosorbent assay （ ELISA ）. Results The positive rates of VCA/IgA, EA/IgA and EBNA1/IgA in NPC group were 97.9%, 81.9% and 87.7% ; those in non - NPC group were 18.0%, 0. 2% and 15.3% ; and those in control group were 5. 1%, 0 and 13.8%, respectively. The positive rates of all three antibodies in NPC group were significantly higher than those in non - NPC group and control group, respectively （ P 〈0. 001 ）. And the positive rate of VCA/IgA in non - NPC group was also significantly higher than that in control group （P 〈0. 001 ）. The sensitivity and specificity of VCA/IgA were 97.9 % and 94.9%, respectively; those of EA/IgA were 81.9% and 100% ; those of EBNAI/IgA were 87.7% and 86.2%. Conclusion The detection of VCA/IgA had higher sensitivity and specificity. There were low sensitivity and the highest specificity of EA/IgA. And the sensitivity and specificity of EBNA1/IgA was lower than those of VCA/lgA. These results suggest that VCA/IgA detected by IE still play important roles in NPC diagnosis, and EBNA1/IgA detected by ELISA remains to be improved further.