EB病毒VCA/IgA、Rta/IgG及EBNA1/IgA抗体水平在鼻咽癌高发区不同人群中的分布

Distribution Analysis for Antibody Levels of Epstein-Barr Virus VCA/IgA,Rta/IgG and EBNA1/IgA in Different Classified Populations from High Risk Area of Nasopharyngeal Carcinoma

目的观察分析鼻咽癌高发区中的鼻咽癌患者、非鼻咽癌头颈部相似疾病患者和健康体检人群中EB病毒VCA/IgA、Rta/IgG及EBNA1/IgA的抗体水平分布情况。方法收集211例未经治疗的鼻咽癌患者、203例头颈部相似症状患者和210例健康体检者的血清,采用免疫酶法检测VCA/IgA,采用酶联免疫吸附法(ELISA)检测Rta/IgG和EBNA1/IgA。应用秩和检验、受试者工作特征(ROC)曲线、多分类logistic回归模型等方法对结果进行分析评价。结果鼻咽癌组的VCA/IgA、Rta/IgG及EBNA1/IgA抗体水平均显著高于头颈部相似疾病组和健康对照组(P<0.001)。头颈部相似疾病组的Rta/IgG及VCA/IgA抗体水平也明显高于健康对照组(P<0.001)。以头颈部相似疾病组和健康体检组为分析人群,分别作相关抗体的ROC曲线,VCA/IgA的ROC曲线下面积为0.565,Rta/IgG抗体的ROC曲线下面积为0.604,具有统计学意义(P<0.05)。综合年龄、性别和3种EB病毒抗体等因素的多分类logistic回归分析显示,鼻咽癌、头颈部相似疾病和健康体检者的预测准确率分别为95.3%、70.9%和55.2%。结论在鼻咽癌高发区EB病毒VCA/IgA及Rta/IgG抗体水平在头颈部相似疾病人群和健康人群中存在一定差异,在鼻咽癌的人群筛查和临床诊断中可根据具体情况设定不同的抗体阳性临界值。

Objective To investigate the distribution of Epstein-Barr virus（EBV）antibody levels of immunoglobulin A（Ig A）against EBV capsid antigens（VCA）,IgG against BRLF1 transcription activator（Rta）and IgA against EBV nuclear antigen-1（EBNA1）in nasopharyngeal carcinoma（NPC）,non-NPC ENT patients and healthy population from high risk area of NPC.Methods Serum samples derived from211 untreated patients with NPC,203 non-NPC ENT patients and 210 healthy volunteers were examined for the presence of VCA/IgA by immunoenzymatic assay,Rta/IgG and EBNA1/IgA by enzyme-linked immnunosorbent assay（ELISA）.Rank-sum test,receiver operating characteristics（ROC）curve and multinomial logistic regression were applied to analyze the research data.Results The antibody levels of VCA/IgA,Rta/IgG and EBNA1/IgA in NPC were significantly higher than those in non-NPC ENT patients and healthy population,respectively（P〈0.001）.The antibody levels of Rta/IgG and VCA/IgA in non-NPC ENT patients were also significantly higher than those in healthy population（P〈0.001）.The results from ROC curve analysis in non-NPC ENT patients and healthy population showed that the areas under ROC curve of VCA/IgA and Rta/IgG had statistical significance（P〈0.05）,which were 0.565 and 0.604,respectively.According to the multinomial logistic regression model analyzed with age,gender and three EBV antibodies,the correct percentages predicted for NPC,non-NPC ENT patients and healthy population were 95.3%,70.9%and 55.2%,respectively.Conclusions There are a certain difference of antibody levels of EBV Rta/IgG and VCA/IgA of non-NPC ENT patients and healthy population from high risk area of NPC.It is feasible to set different critical values of EBV antibodies for facilitating population screening and clinical diagnosis of NPC.