联合检测EB病毒相关抗体和抗原对诊断鼻咽癌的价值

背景与目的：近年来随着分子生物学的发展，提供了多项EB病毒（Epstein-Barrvirus）相关的检测指标。本研充通过同时检测EB病毒VCA-IgA、EA、IgA、EBV-特异性DNA酶（EBV-DNase）抗体、EB病毒DNA（EBV-DNA），评价联合检测对诊断鼻咽癌的价值。方法：收集160例治疗前的鼻咽癌患者和76例健康成人的血清和血浆，应用免疫酶染色法检测血清VCA-IgA、EA-IgA：用正丁酸与巴豆油激发Raji细胞方法检测EBV-DNase抗体：用实时荧光定量聚合酶链反应（real-timefluoresc,eneequantitativePCR，RQ．PCR）分析血浆EBV-DNA，评什其在诊断鼻咽癌中的价值。结果：单项检测时对鼻咽癌患者诊断的敏感性和特异性分别为：VCA-IgA90．0％、89．5％，EA-IgA75．0％、94．7％，EBV-DNase抗体76．3％、90．8％，EBV-DNA68．8％、88．2％。联合检测的敏感性和特异性分别为98．8％和84．2％。VCA-IgA、EA-IgA阳性率与临床分期无关（P〉0．05），各临床分期中EBV-DNase抗体阳性率、EBV-DNA水平与阳性率的差异有统计学意义（P〈0．05）。结论：VCA-IgA、EA-IgA、EBV-DNase和EBV-DNA单项检测时VCA-IgA敏感性最高，EA-IgA特异性最好；四项指标联合检测可提高鼻咽癌诊断的敏感性和准确度。EBV-DNase抗体、EBV-DNA有助于评估鼻咽癌病程和协助判断临床分期。

Combined determination of Epstein-Barr virus-related antibodies and antigens for diagnosis of nasopharyngeal carcinoma

Background and Objective： With the development of molecular biology in recent years, many indexes for detecting Epstein-Barr virus （EBV） have been developed. This study was to evaluate the diagnostic value of combined determination of EBV-related antibodies and antigens, including VCA-IgA, EA-IgA, EBV-DNase antibody and EBV-DNA, in diagnosing nasopharyngeal carcinoma （NPC）. Methods： Serum and plasma samples from 160 untreated NPC patients and 76 healthy donors were collected. VCA- IgA and EA-IgA in the serum samples were detected by immunoenzyme staining method. Raji cells were stimulated by ortho-butanoic acid and croton oil to detect EBV-DNase antibody. The content of EBV-DNA in the plasma samples was detected by real-time fluorescence quantitative polymerase chain reaction （RQ-PCR）. The diagnostic values of the indexes for NPC were evaluated. Results： The sensitivity and specificity for diagnosing NPC were 90.0% and 89.5% for VCA-IgA, 75.0% and 94.7% for EA-IgA, 76.3% and 90.8% for EBV-DNase antibody, 68.8% and 88.2% for EBV-DNA, and 98.8% and 84.2% for combined determination. The positive rates of VCA-IgA and EA-IgA had no relationship with clinical stage of NPC （P〉0.05）; nevertheless, the positive rates of EBV-DNase antibody and EBV-DNA were related with clinical stage （P〈0.05）. Conclusions： The sensitivity of VCA-IgA and the specificity of EA-IgA are the highest while detecting solely. Combined determination could improve the diagnostic sensitivity and accuracy for NPC. EBV-DNase antibody and EBV-DNA could be helpful to evaluate the course of disease and classify the clinical stage of NPC.