聚合酶链反应检测EB病毒DNA在鼻咽癌诊断中的应用

Detection of Epstein- Barr virus withpolymerase chain reaction in diagnosis fornasopharyngeal carcinoma

流行病学、血清学和分子生物学的资料证实，爱泼斯坦－巴尔病毒（ＥＢＶ感染与鼻咽癌（ＮＰＣ）有密切关系。血清ＥＢＶ－ＶＣＡ－ＩｇＡ，ＥＢＶ－ＥＡ－ＩｇＡ测定和聚合酶链（ＰＣＲ）检测组织中ＥＢＶ－ＤＮＡ已用于ＮＰＣ的临床诊断。本文评价上述方法在ＮＰＣ诊断中的实用价值。８５例病人双盲法测定血清ＥＢＶ－ＶＣＡ－ＩｇＡ（Ｉ），ＥＢＶ－ＥＡ－ＩｇＡ（Ⅱ）：鼻咽活检组织用ＰＣＲ法检测ＥＢＶ－ＤＮＡ（Ⅲ）和组织病理检测（Ⅳ）。组织病理学证实：ＮＰＣ５７例；非ＮＰＣ２８例作为对照组。５７例ＮＰＣ中，（Ⅰ）、（Ⅱ）、（Ⅲ）的阳性率分别为６６．７％，２１．１％，８０．７％；（Ⅰ）＋（Ⅱ），（Ⅰ）＋（Ⅲ），（Ⅱ）＋（Ⅲ）或（Ⅰ）＋（Ⅱ）＋（Ⅲ）的阳性率分别为２１．１％，５６．１％，１９．３％，１９．３％（Ｐ＜０．００５）。２８例对照组（Ⅰ）、（Ⅱ）或（Ⅲ）的阴性率分别为７５％，１００％，１００％；（Ⅰ）＋（Ⅱ），（Ⅰ）＋（Ⅲ），或（Ⅰ）＋（Ⅱ）＋（Ⅲ）均为对．４％（Ｐ＜０．００５）。本组结果提示，ＰＣＲ法检测ＥＢＶ－ＤＮＡ具有灵敏度高（ＮＰＣ的阳性率高）和特异性强（对照组的阴性率高）的特点。

It is well known that Epstein-Bars virus (EBV) has been linked to nasopharyngeal carcinoma (NPC) on the basis of epidemiological, serological and molecular biological data. Determination of titres of antibodies to EBV in serum-EBV-VCA-IgA, EBV - EA - IgA, and assay of EBV-DNA in tissue of patients with polymerase chain reaction (PCR) has been used for diagnosis of NPC. This paper evaluated the value of both assay mentioned above in the use for diganosis of NPC.85 patients were investigated.For each patient, determination of EBV- VCA-IgA(Ⅰ), EBV-EA-IgA (Ⅱ) in serum, EBV-DNA assay with PCR (Ⅲ) and histo-pathological examination (Ⅳ) of biopsy of nasopharyngeal tissue were performed with double-blind studies. 57 patients with NPC were confirmed by histo-pathopathological examination, and 28 patients were proven histo-logically non-NPC and served as control. Of 57 NPC, the positive rate of (Ⅰ). (Ⅱ ) or (Ⅲ) were 66.7%,21.1%,80.7% respectivelly,and (Ⅰ )+(Ⅱ), (Ⅰ)+(Ⅲ),(Ⅱ)+(Ⅲ),or(Ⅰ)+(Ⅱ)+(Ⅲ) were 21.1%, 56. 1%, 19.3%, 19.3% (P<0. 005).For 28 control cases, the negative rate of (Ⅰ ). (Ⅱ) or (Ⅲ)were 75%,100%, 100% respectivelly,and(Ⅰ)+(Ⅱ),(Ⅰ )+(Ⅲ), or (Ⅰ ) +(Ⅱ)+(Ⅲ)were 71.4%, 71.4%, 71.4% (P<0.005). Our results suggested that assay of EBV-DNA with PCR have best sensitivity (positive rate of NPC is high) and specificity (negative rate of control is high)for diagnosis of NPC and could be used in early diagnosis of NPC.