检测EB病毒ZEBRA/IgG抗体在鼻咽癌早期诊断和预后判断上的意义

The singnificance of EB virus ZEBRA/IgG in early diagnosis and prognosis of nasopharyngeal carcinoma(NPC)

目的：通过检测血清中的ＺＥＢＲＡ／ＩｇＧ，研究这一指标在鼻咽癌的早期诊断及预后判断上的价值。方法：对四会地区人群筛查血清库及鼻咽癌治疗后不同转归的病人的血清标本，用ＥＬＩＳＡ法检测血清中的ＺＥＢＲＡ／ＩｇＧ。结果：鼻咽癌组ＺＥＢＲＡ／ＩｇＧ的阳性率为９０９％，明显高于各对照人群（Ｐ均＜００１）。在四会地区自然人群、单阳人群及高危人群中，ＺＥＢＲＡ／ＩｇＧ的阳性预测值分别为３３％、３８％和２３１％。ＺＥＢＲＡ／ＩｇＧ平均在鼻咽癌病理确诊前３５年已出现阳性，且全部鼻咽癌病例从首次检测ＺＥＢＲＡ／ＩｇＧ到病理确诊时抗体水平逐渐升至最高。鼻咽癌治疗后，ＺＥＢＲＡ／ＩｇＧ的水平随病情变化而消长。高水平抗体（Ｐ／Ｎ≥７０）阳性率，远处转移组高于局部复发和无瘤生存组。结论：用ＥＬＩＳＡ法检测ＺＥＢＲＡ／ＩｇＧ可作为一种鼻咽癌辅助诊断的方法。在鼻咽癌高发区不同血清特征的人群中，计算出ＺＥＢＲＡ／ＩｇＧ阳性预测值，可为临床医生制定临床决策提供依据。ＺＥＢＲＡ／ＩｇＧ的抗体值与抗体的动态变化相结合，可用作癌前阶段高危人群及预后判断的监测指标。

bjective:This study was performed to investigate the value of ZEBRA/IgG in early diagnosis and prognostic judgement of NPC by detecting ZEBRA/IgG. Methods: The sera were taken from the sera bank of screening population in Sihui area and the patients with different outcomes after radiotherapy. ZEBRA/IgG was detected dy ELISA(enzyme-linked immunosorbent assay). Result:The positive rate of ZEBRA/IgG in NPC patients was 90.9%,which was significantly higher than that of the contrast groups(All of the P value <0.01).The positive predictive value was calculated for nature population(3.3%),the VCA/IgA positive persons(3.8%)and high risk persons(23.1%)in Sihui area.Average ZEBRA/IgG positive time was 3.5 years before NPC was pathologically diagnosed and the level of ZEBRA/IgG gradually increased to the highest point until the time when NPC was pathologicall detected in all of the NPC patients.The level of ZEBRA/IgG changed according to the patients condition after therapy.The percentage of high level of ZEBRA/IgG(P/N≥7.0)was significantly higher than the local recurrence group and diease-free group. Conclusion:Detection of ZEBRA/IgG with ELISA method is an useful method for diagnosis.The ZEBRA/IgG positive level can be an indicator for prognosis in the area with high NPC incidence.ZEBRA/IgG can also be a marker for monitiring the high risk individuals in precancerous period and the outcomes of NPC patients after therapy.The level of ZEBRA/IgG and its changing should be combined in consideration.