鼻咽癌患者血清唾液酸动态观察

目的探讨血清唾液酸(sialicacid,SA)在鼻咽癌的诊断价值及作为病情动态监测指标的可行性。方法对50例鼻咽癌患者治疗前、治疗结束时、治疗后2年的血清唾液酸进行检测,并与EB病毒衣壳抗原免疫球蛋白A(Epstein-Barrvirus-viralcoatantigensIgA,EBVVCA-IgA)作比较;以健康成年人、头颈部良性病变者各50例,作为对照。结果鼻咽癌患者治疗前血清唾液酸和EBV-VCA-IgA阳性率均明显高于健康人,差异有统计学意义(P值均<0.01);不同时期血清唾液酸与EBVVCAIgA平均值呈明显正相关。血清唾液酸在鼻咽癌患者治疗前、后及随访期变化差异有统计学意义(P<0.01),治疗前阳性率达94.0%(47/50),治疗结束时阳性率2.0%(1/50),随访期有复发者阳性率96.2%(25/26),未复发者阳性率4.2%(1/24);而EBVVCAIgA变化不太明显。作为诊断试验,血清唾液酸对鼻咽癌的敏感度为94.0%,高于EBVVCAIgA的90.0%;特异性为93.0%,低于EBV-VCA-IgA的96.0%。结论血清唾液酸可能成为鼻咽癌病情变化的动态监测指标,结合EBV-VCA-IgA的检测,可用于高危人群的普查、筛选,以及对临床疗效的判断和预后的评估。

Dynamic observation on serum sialic acid in nasopharyngeal carcinoma patients

Objective To discuss the diagnostic value and possibility to be a dynamic monitoring index of serum sialic acid (SA) in nasopharyngeal carcinoma (NPC) patients. Methods Serum SA and Epstein-Barr virus-viral coat antigens-IgA (EBV-VCA-IgA) were detected in 50 cases of NPC before treatment, after clinical recovery and recurrence. Healthy adult and patients of benign lesions of head and neck were also detected as controls. Results SA and EBV-VCA-IgA were positively related significantly in different periods of NPC patients. SA was significantly varied dynamically before and after radiation and chemical therapy in NPC patients. The positive rate of SA was 94.0%(47/50) before treatment, 2.0%((1/50)) after clinical recovery, 96.2%(25/26) in recurrent patient and 4.2%(1/24) in patients without recurrence. The reaction of EBV-VCA-IgA was slow and its corresponding positive rates were 90.0%, 90.0%,84.6%,0%and 75.0% respectively. The sensitivity of SA in pre-treated NPC patients was 94.0%,higher than EBV-VCA-IgA(90.0%). The specificity of serum SA was 93.0% in this series,lower than that of EBV-VCA-IgA(96.0%). Conclusion Dynamic detections of serum SA combined with EBV-VCA-IgA can be used as indices in dicating the changes in NPC patients and screening of high-risk population, judgment of curative effect and prediction of prognosis.