鼻咽癌患者的EB病毒IgM/VCA抗体反应的研究

IGM ANTIBODY TO EPSTEIN-BARR VIRUS AND NASOPHARYNGEAL CARCINOMA

本文应用免疫酶法检测了162例鼻咽癌、34例鼻咽癌粘膜病变、41例其他肿瘤和80例正常人(其中35例已知IgA/VCA抗体阳性)血清中IgM/VCA抗体,并与IgA/VCA和IgA/EA抗体进行比较。发现鼻咽癌患者血清中不仅含有高滴度的IgA/VCA抗体,而且含有高滴度的IgM/VCA抗体,阳性率(≥1:10)分别为97.53％和93.20％,GMT为157.60和95.75。两种抗体水平均明显高于其他对照组。有临床分期的62例鼻咽癌患者的IgM抗体水平,有随病程进展而略有升高的趋势。提示鼻咽癌患者体内的EB病毒慢性持续感染和活跃的复制。 鼻咽癌患者与IgA/VCA阳性的正常人血清中IgA/VCA和IgM/VCA抗体双阳性率分别为92.0％和31.43％;IgA/VCA和IgA/EA抗体双阳性率为48.76％和14.29％。鼻咽癌患者血清中,前者双阳性率高于后者双阳性率,且与正常相比有显著差异(P<0.01)。表明IgA/VCA和IgM/VCA抗体一起作为早期发现鼻咽癌的血清学指标,可能优于沿用的IgA/VCA和IgA/EA指标,操作和成本亦较方便和便宜。

A comparative study of IgA/VCA and IgM/VCA antibodies was carried out, by the method of indirect immunoperoxidae assay (IPA) , with 162 cases of nasop haryngeal carcinoma (NPC), 34 cases of nasopharyngeal lesions (NPL), 41 cases of tumors other then NPC and 80 cases of healthy donors. It was found that sera from NPC patient nts contained not only a high liter of IgA/VCA antibody but also a high level of IgM/VCA antibody, the positive rate (≥1 : 10) were 97.53% and 93.20% respectively; the GMT were 1 : 157.60and 1 :95.75, respectively. The differentes of IgM/VCA antibody levels between NPC and other groups are statistically very significant.In the NPC group, the antibody level is slightly higher in the advanced stage of NPC than in the early stage.The double, positive rate of IgA and IgM antibodies to VCA in NPC and healthy donor groups were 92.0% and 31.43% respectively, showing a higher double positive rate than the IgA antibodies to VCA and EA in both groups (48.76%and 14.29%respectively). It is suggested that to use the examination of IgA and IgM antibodies to VCA instead of the IgA antibodies to VCA and EA will be much more convenient and effective in the early detection of NPC.