EB病毒DNA载量检测在门诊诊断鼻咽癌患者中的应用价值

The value of Epstein-Barr virus DNA load detection in the outpatient with NPC

目的探讨EB病毒DNA(EBV-DNA)载量检测在门诊诊断鼻咽癌患者中的应用价值。方法收集61例门诊就诊的可疑鼻咽癌患者,同时进行EBV-DNA载量、EBVVCA-IgA和EBVEA-IgA检测,并与病理组织切片检查作比较。结果病理组织切片检出鼻咽癌47例;EBV-DNA载量、EBVVCA-IgA、EBVEA-IgA检测的灵敏度分别为76.6%(36/47)、55.3%(26/47)和45.8%(22/48);特异度分别为64.3%(9/14)、71.4%(10/14)和92.3%(12/13);正确率分别为73.8%[(36+9)/61]、59.0%[(26+10)/61]和55.7%[(22+12)/61];三种检测方法阳性检出率与病理组织切片检查比较,除EBV-DNA载量检测差异无统计学意义(P>0.05)外,其余两法均低于病理组织切片检查(P均<0.01);EBV-DNA载量、EBVVCA-IgA和EBVEA-IgA三种方法检测在NPC组和对照组及NPC临床分期的中位滴度,除EBV-DNA载量检测差异有统计学意义(P<0.01)外,其他两法差异均无统计学意义(P均>0.05)。结论在这三种鼻咽癌的筛查技术中,EBV-DNA载量检测优于EBVVCA-IgA和EBVEA-IgA检测。

Objective To study the value of Epstein-Barr virus DNA load detection in the outpatient with nasopharyngeal carcinoma（NPC）. Methods Sixty-one outpatients with suspected NPC were detected respectively EBV-DNA load, EBV VCA-IgA and EA-IgA, and compared with histopathological diagnosis. Results Those cases were detected 47 cases of nasopharyngeal carcinoma through histopathology. The sensitivities of EBV-DNA load, VCA-IgA and EA-IgA were 76. 6% （ 36/47 ）, 55.3 % （ 26/47 ） , and 45.8 % （ 22/48 ） respectively ; the specificities were 64. 3 % （9/14 ）, 71.4% （ 10/14 ）, and 92. 3 % （ 12/13 ） respectively ; the accuracies were 73.8 % [ （ 36 ＋ 9 ） / 61 ] ,59.0% [ （26 ＋ 10）/61 ], and 55.7% [ （22 ＋ 12）/61 ] respectively. Compared with histopathology, the positive rate of the three detection methods except EBV-DNA load showed no significant difference（P 〉 0. 05 ）, the other weresignificant difference（P 〈0.01 ）; The methods of EBV-DNA load, VCA-IgA and EA-IgA were performed between NPC and control groups, and among NPC clinical stages, except that the detection of EBV-DNA load was significant difference （ P 〈 0. 01 ）, the other were no significant difference （ P 〉 0. 05 ）. Conclusion In three kinds of nasopha- ryngeal cancer screening technology, EBV-DNA load was better than EBV VCA-IgA and EA-IgA.