聚合酶链反应检测EB病毒亚型对区分鼻咽良恶性病变的价值

The Value of Polymerase Chain Reaction on Epstein-Barr Virus Subtypes in the Differentiation of Benign and Malignant Nasopharyngeal Biopsies

以ＥＢ病毒核抗原（ＥＢＮＡ）Ａ亚型特异性引物作聚合酶链反应（简称ＰＣＲ－Ａ），同时用Ａ、Ｂ亚型ＤＮＡ片段和Ｂａｍ－Ｗ片段为探针，与鼻咽活检组织ＤＮＡ作打点核酸杂交（简称ＤＢＨ－Ａ、ＤＢＨ－Ｂ和ＤＢＨ－Ｗ）。ＤＢＨ－Ｂ结果全部阴性，ＰＣＲ－Ａ、ＤＢＨ－Ａ和ＤＢＨ－Ｗ检测的阳性率，３１例鼻咽癌分别为８３．９％（２６／３１）、７４．２％（２３／３１）和８０．６％（２５／３１）；３３例非鼻咽癌分别为１５．２％（５／３３）、６９．７％（２３／３３）和４２．２％（１４／３３），其中２５例慢性鼻咽炎分别为１２．０％（３／２５）、９２．０％（２３／２５）和４０．０％（１０／２５）。鼻咽癌组与非癌组和慢性鼻咽炎之间，ＰＣＲ－Ａ阳性率的差异有非常显著的统计学意义（Ｐ＜０．０００１），可作为区别鼻咽良恶性病变的一个有价值的参考指标。这为鼻咽癌的病毒发病学提供了有价值的线索，也使将来用ＰＣＲ早期诊断鼻咽癌成为可能。

Polymerase chain reaction(PCR)of Epstrin-Barr virus(EBV) EBNA-2 type A(PCR-A)along with dot blot hybridization using EBV DNA Bam-W and EBNA-2 type A and B fragment as the probes(DBH-W,-A,and -B)was performed in the nasopharyngeal biopsies.The positive rates of PCR-A,DBH-W,-A and -B were 83.9%,80.6%,74.2% and 0.0% in 31 cases of nasopharyngeal carcinoma(NPC),respectively.However,15.2%, 42.2%,69.7% and 0.0% in 33 cascs of non-NPC groups,respectively,and 12.0%40.0%,92.0/and 0.0%in 25 cases of chronic nasopharyngitis(NP),respectively. There were significant differences between NPC and NP or non-NPC(P<=0.0001)detected by PCR-A.The results indicated that positive PCR-A would be valuable for early di-agnosis of nasopharyngcal carcinoma.The reasons which might make those differences were discussed.