酶联免疫吸附检测血清EB病毒VCA-IgA和EA-IgG诊断鼻咽癌

目的：评估采用酶联免疫吸附（ELISA）检测VCA－IgA和EA－IgD在鼻咽癌血清学诊断中的价值。方法：收集33例鼻咽癌患者和58例健康成年人的血清，用EISA检测VCA－IgA和EA－IgG，用免疫酶标法（IE）检测VCA－IgA和EA－IgA，并对两种检测方法的结果进行比较。结果：用ELISA和IE检测VCA－IgA的灵敏度均为0．9697。ELISA检测EA－IgG灵敏度（0．8788）高于IE检测EA－IgA（0．7879）。ELISA联合检测VCA－IgA和EA－IgG灵敏度（0．8485）高于IE联合检测VCA－IgA和EA－IgA（0．7879）。ELISA检测VCA－IgA和EA－IgG，33例鼻咽癌患者中，28例为双阳性，1例VCA－IgA阴性者EA－IgG阳性；4例EA－IgG阴性者VCA－IgA阳性。ELISA分别检测VCA－IgA和EA－IgG，9例无颈淋巴转移者与24例有颈淋巴结转移者两组均数之间均无统计学差异；19例临床早期患者（Ⅰ期和Ⅱ期）和14例晚期患者（Ⅲ期和Ⅳ期）两组均数之间亦均无统计学差异，结论：ELISA检测血清VCA－IgA和EA－IgG完全可以替代IE检测血清VCA－IgA和EA－IgA，获得更客观，有效的鼻咽癌血清学诊断，ELISA检测VCA－IgA和EA－IgG，这两个指标在鼻咽癌血清学诊断中具有互补作用，应联合应用，ELISA检测VCA－IgA和EA－IgG数值大小能反映鼻咽癌患者有无淋巴结转移及临床分期的早期。

Detection of serum Epstein-Barr virus VCA-IgA and EA-IgG by ELISA for diagnosis of nasopharyngeal carcinoma

Objective To evaluate the value of Epstein-Barr virus VCA-IgA and EA-IgG tests using enzyme-linked immunosorbent assay (ELISA) for serological diagnosis of nasopharyngeal carcinoma (NPC). Methods Thirty-three sera of patients with NPC and 58 sera from healthy adults were collected. ELISAs for detecting VCA-IgA and EA-IgG and immunoenzymatic method (IE) for detecting VCA-IgA and EA-IgA were used and compared. Results The sensitivity of VCA-IgA using ELISA ( 0.969 7 ) was the same as that by using IE. The sensitivity of EA-IgG using ELISA ( 0.878 8 ) was higher than that of EA-IgA by using IE ( 0.787 9 ). The sensitivity of combined ELISA for VCA-IgA and EA-IgG ( 0.848 5 ) was higher than that of combined IE for VCA-IgA and EA-IgA ( 0 787 9 ). Sera from twenty-eight of 33 patients showed both positivity with VCA-IgA and EA-IgG by ELISA. One patient with negative VCA-IgA showed positive response to EA-IgG and 4 patients with negative EA-IgG showed positive VCA-IgA. The mean value of either VCA-IgA or EA-IgG in 9 patients without lymph node metastasis was not significantly different from that in 24 patients with lymph node metastasis by using ELISA. There was also no significant difference between patients with stage I or II (19 cases) and patients with stage III or IV (14 cases). Conclusion The VCA-IgA and EA-IgA tests using IE can be substituted by VCA-IgA and EA-IgG using ELISA, which is more objective and efficient in serological diagnosis of NPC. The two ELISAs, namely, VCA-IgA and EA-IgG, have complementary effect on serological diagnosis of NPC. The relative A value (or relative optic density) against VCA or EA of NPC patients can not be used as an indicator of TNM staging.