血浆EBV DNA水平与EBVCA-IGA抗体滴度对鼻咽癌诊断作用的对比研究

Comparison of plasma epstein-barr virus(EBV) DNA levels and EBV immunoglobulin A/virus capsid antigen antibody titers in patients with nasopharyngeal carcinoma

目的比较研究血浆EBV DNA水平与EBVCA-IGA抗体滴度对鼻咽癌的诊断作用。方法73例初治鼻咽癌患者经病理确诊,按福州会议"1992鼻咽癌分期"进行TNM分期,检测患者空腹血浆EBV DNA水平和EBVCA-IGA抗体滴度。采用SPSS13.0统计软件对资料进行比较,结合临床资料对结果进行分析。结果血浆EBV DNA水平与EBVCA-IGA抗体滴度对鼻咽癌的诊断作用比较,差异有统计学意义,血浆EBV DNA的诊断特异性明显高于后者;血浆EBV DNA水平在有、无淋巴结转移组间的比较,差异有统计学意义(P<0.05)。结论与EBVCA-IGA抗体滴度相比,血浆EBV DNA对NPC诊断有较高特异性;血浆EBV DNA水平可能预示鼻咽癌淋巴结转移。

[Objective] To compare the levels of plasma Epstein-Barr virus （EBV） DNA with the titers of EBV-CA-IGA among the same group of nasopharyngeal carcinoma （NPC） patients in the diagnosis of NPC. [Methods] Patients with histologically confirmed NPC attending the otorhinolaryngology and head and neck department, the first aftliated hospital of Guangxi medical university were recruited for this study. Disease stage was determined in accordance with the Fuzhou, 1992 TNM classification system. Real-time quantitative polymerase chain reaction （real-time quantitative PCR） was used for quantitative detection of plasm samples of 73 cases of primary NPC, whose blood samples were collected in their state of empty stonmtch, and the enzyme-linked immunoassays were used to measure the titers of EBVCA- IGA, analysed in statistical combined with the clinical data was done by the SPSS version 13.0, difference was considered significant when P value was 〈0.05. [Results] It has significant statistical value of the comparison of the EBV DNA with the EBV CA-IGA among the same NPC patients （P 〈0.05）, and the positive rate of diagnostic value by EBV DNA was higher than that of the EBVCA-IGA. The levels of plasm EBV DNA and the liters of EBVCA-IGA between the lymphatic and non-lymphatic extention groups were statisticed by SPSS 13.0 too, and it appeared that the former had a significant statistic value （P 〈0.05）, and the higher plasm level of EBV DNA might mean the lymphatic extention. [Conclusion] Plasm EBV DNA concentration might be a candidate molecular index in the diagnosis of NPC, the patient of NPC with higher plasma EBV DNA may be a sign of lymphatic extention. The results suggest that plasma EBV DNA detection is a more sensitive and specific marker than the serum EBVCA-IgA titer for the diagnosis and monitoring of patients with NPC. The clinical application of plasm EBV DNA may be a fairly perspective candidate molecular symbol both in the diagnosis and in improving the prognosis of NPC.