六种抗EB病毒抗体检测在鼻咽癌血清学诊断中的比较

目的:评估EBNA1-IgA,EBNA1-IgG,Zta-IgA,Zta-IgG,VCA-p18-IgA和VCA-p18-IgG六种酶联免疫吸附检测(ELISA)在血清学诊断鼻咽癌中的应用,探讨哪种ELISA组合更有功效.方法:收集85例治疗前鼻咽癌患者和132例健康成人血清.应用六种EB病毒特异性重组融合蛋白ELISA,检测血清抗EB病毒的抗体水平.采用灵敏度、特异度、优势比等参数来评估它们在诊断鼻咽癌中的效率.结果:单独采用一种检测时,Zta-IgG和EBNA1-IgA的灵敏度与特异度均可达0.8106以上.Zta-IgG/EBNA1-IgG和Zta-IgG/EBNA1-IgA两种检测双阳性的特异度提高至0.9621以上.Zta-IgG/EBNA1-IgA/EBNA1-IgG或Zta-IgG/EBNA1-IgG/Zta-IgA三种检测均阳性者,其特异度不仅可达0.9824,优势比也明显升高(分别为206.4242和196.5000).85例患者血清中无1例同时呈Zta-IgG/EBNA1-IgA/EBNA1-IgG阴性者.结论:临床血清学诊断鼻咽癌,首选Zta-IgG或EBNA1-IgA.同时检测两种ELISA,宜采用Zta-IgG/EBNA1-IgA或Zta-IgG/EBNA1-IgG.三种ELISA同时检测,可以提高特异度.推荐Zta-IgG/EBNA1-IgA/EBNA1-IgG或Zta-IgG/EBNA1-IgG/Zta-IgA三项.

Comparison of 6 Antibody Assays Detecting Epstein-Barr Virus for Serodiagnosis of Nasopharyngeal Carcinoma

Objective: To assess 6 enzyme-linked immunosorbent assays (ELISA), namely, EBNA1-IgA, EBNA1-IgG, Zta-IgA, Zta-IgG, VCA-p18-IgA and VCA-p18-IgG, for their application in serodiagnosis of nasopharyngeal carcinoma (NPC), and to investigate what combinations of ELISAs were more efficient. Methods: The sera of 85 pretreated NPC patients and 132 healthy adults were collected. Six ELISAs using Epstein-Barr virus (EBV) -specific recombinant fusion proteins were applied to test the serum antibody level against EBV. Sensitivity, specificity, odds ratio and other parameters were evaluated to determine the efficiency of diagnosing NPC. Results: When evaluated individually, the sensitivity and specificity of Zta-IgG and EBNA1-IgA could both reach more than 0.8106. The specificity of dual positives for Zta-IgG/EBNA1-IgG and Zta-IgG/EBNA1-IgA increased to more than 0.9621. The triple positivity for Zta-IgG/EBNA1-IgA/EBNA1-IgG and Zta-IgG/EBNA1-IgG/Zta-IgA could not only enhance the specificity toward 0.9824 but also significantly elevate the odds ratio (206.4242 and 196.5000 respectively). None of the 85 NPC patients' sera were negative when the Zta-IgG/EBNA1-IgA/EBNA1-IgG tests were conducted concurrently. Conclusions: When using a single ELISA merely for serodiagnosis of NPC, the best choice is either the Zta-IgG or EBNA1-IgA. In order to enhance the specificity, the combined usage of 2 ELISAs, namely, Zta-IgG/EBNA1-IgA or Zta-IgG/EBNA1-IgG, was appropriate. Three ELISAs used concurrently could not only enhance the specificity, but also meet the requirement of excluding suspicious NPC patients serologically. Two combinations of 3 ELISAs, namely, Zta-IgG/EBNA1-IgA/EBNA1-IgG and Zta-IgG/ EBNA1-IgG/Zta-IgA were recommended.