联合检测EB病毒不同抗体及EB病毒DNA在鼻咽癌血清学诊断中的价值

目的:评价EB病毒(EBV)抗衣壳抗原VCA-IgA抗体、抗早期抗原EA-IgA抗体、抗立即早期抗原Rta-IgG抗体和EBV-DNA检测在鼻咽癌诊断中的价值。方法:收集160例初治鼻咽癌，133例症状相似的非鼻咽癌患者和163名健康体检者的血清和血浆。采用酶联免疫法检测血清VCA-IgA、EA-IgA和Rta-IgG抗体的水平，用实时荧光定量PCR检测血浆EBV-DNA的相对含量。按鼻咽癌2008临床TNM分期法进行分期，计算不同分组、各临床分期以及鼻咽癌治疗前后的各抗体阳性率、抗体水平以及EB-DNA的检测结果并进行数据分析。结果:鼻咽癌组VCA-IgA、EA-IgA、Rta-IgG和EBV-DNA阳性率均高于鼻咽相关疾病组及健康对照组（均P<0.05）。血清VCA-IgA和EA-IgA结果相对A值（即rA或S/CO值）在Ⅰ、Ⅱ期低于Ⅲ、Ⅳ期，差异有统计学意义(P<0.05)，但阳性率在各期间比较差异无统计学意义(P>0.05)；Ⅰ、Ⅱ期患者Rta-IgG的rA值和阳性率明显低于Ⅲ、Ⅳ期患者(P<0.05)；血浆中EBV-DNA阳性率及EBV-DNA中位数水平随着临床分期的升高而增高，Ⅰ、Ⅱ期与Ⅲ、Ⅳ期比较差异有统计学意义（P<0.05）。治疗有效（CR+ PR）患者的EBV-DNA含量明显低于治疗前水平（P<0.05）。结论:VCA-IgA、EA-IgA、Rta-IgG、EBV-DNA检测有助于鼻咽癌的辅助诊断、临床分期预测及疗效评估。

Diagnostic value of serological Epstein-Barr viral antibodies and Epstein-Barrviral DNA assays in the management of nasopharyngeal carcinoma

Objective:To evaluate the diagnostic value of EB viral VCA-IgA,EA-IgA,Rta-IgG and EB viral DNA for nasopharyngeal carcinoma(NPC).Methods:Serum and plasma samples were collected from 160 untreated NPC patients,133 non-NPC patients with NPC-like symptoms and 163 healthy donors.ELISA was performed to de-tect VCA-IgA,EA-IgA and Rta-IgG antibodies in sera and Real-time fluorescent quantitative PCR was used for measuring EBV DNA in plasma.According to the NPC 2008 clinical staging TNM classification,different groups,the clinical staging and before or after treatment of NPC that the difference of each antibody positive rate,antibody levels and EB-DNA test results were analyzed.Results:The positive rates of VCA-IgA,EA-IgA,Rta-IgG,EBV -DNA in NPC group were higher than those in nasopharyngeal related diseases and healthy control group(P<0.05). Patients inⅠ,Ⅱ stage yielded lower expression level(rA)of EBVCA-IgA and EA-IgA than those in Ⅲ,Ⅳ stage (P<0.05),but the positive rates revealed no statistically significant between these two groups(P>0.05).Addition-ally,EB Rta-IgG in patients with Ⅰ,Ⅱ stage harbored lower expression level(rA)and positive rates when com-pared to the cases inⅢ,Ⅳstage(P<0.05).Of note,the positive rate and the median level of EBV-DNA increased along with the clinical stages,and significant difference was observed between stageⅠ,ⅡandⅢⅣ(P<0.05).Pa-tients with effective treatment(CR +PR)displayed reduced EBV -DNA level than that before treatment(P<0.05).Conclusion:VCA-IgA,EA-IgA,Rta-IgG,EBV-DNA can be utilized as useful biomarkers for NPC diag-nosis as well as the clinical stage prediction and therapeutic efficacy monitoring.