联合检测血清唾液酸和EBVCA-IgA对鼻咽癌诊断及疗效监测的意义

Significance of detection of serum sialic acid and Epstein-Barr virus VCA-IgA in diagnosis and monitoring radiotherapy effectiveneness in nasopharyngeal carcinoma patients

目的探讨联合检测血清唾液酸(SA)和EB病毒壳抗原IgA抗体(EBVCA-IgA)在鼻咽癌(NPC)患者诊断及疗效监测中的意义。方法对65例NPC患者治疗前、治疗结束后1个月、和21例治疗后1年出现局部复发或远处转移者,50例头颈部良性病变患者及50例正常人血清SA与EBVCA-IgA进行联合检测。结果NPC患者治疗前血清SA和EBVCA-IgA阳性率均明显高于正常人和头颈部良性病变患者,差异有统计学意义(均P<0·01);联合检测敏感性达到96·9%,明显高于SA、EBVCA-IgA的单项检测(P<0·05),同时特异性仍有91·0%。与NPC治疗前组比较,NPC治疗后组和未复发组的血清SA水平明显下降(P<0·01),NPC治疗后复发组较未复发组患者的血清SA水平明显上升(P<0·01),而EBVCA-IgA的阳性率的变化却不明显。结论血清SA水平可作为判断NPC疗效及监测病情的一种有效手段,联合检测血清SA水平和EBVCA-IgA阳性率,可明显提高NPC患者的阳性检出率。

Objective To understand the significance of detection of serum sialic acid （SA） and Epstein- Barr virus VCA-IgA （EBVCA-IgA） in diagnosis and monitoring radiotherapy effectiveneness of nasopharyngeal carcinoma（NPC） patients. Methods Serum SA and EBVCA-IgA were detected in 65 cases with NPC before radiotherapy and one months after radiotherapy and 21 cases one year after radiotherapy for NPC with local recurrence and/or distant metastasis. Healthy persons and patients with benign lesions of head and neck were also enrolled as control group. Results SA and EBVCA-IgA of NPC patients before radiotherapy were significantly higher than those in control group （ P 〈 0.01 ）. The sensitivity of combination of SA and EBVCA-IgA （96.9%） was higher than those determined alone（ P 〈 0.05 ）. The SA level of NPC patients after radiotherapy and without recurrence after radiotherapy was reduced significantly compared to the NPC patients before radiotherapy （ P 〈 0.01）. The SA level of NPC patients with recurrence was significantly higher than that in NPC patients without recurrence （ P 〈 0.01 ）, whereas the positive rate of EBVCA-IgA changed little. Conclusion Dynamic detections of serum SA may be a valuable technique for diagnosis and monitoring radiotherapy effectiveneness in NPC patients. The combined determination of the two indexes can raise the positive rate of patients with NPC.