17175例体检人群中EB病毒抗体阳性结果分析

Analysis of 17 175 cases with results of physical examination crowd EB virus antibody positive

目的了解鼻咽癌人群与EB病毒核抗原1（NA）Iga抗体、衣壳抗原（VCA）IgA抗体、Zta蛋白Iga抗体阳性的关系。方法采用酶联免疫法对17175例血清进行EB病毒VCA-IgA、NAl-IgA和Zta—IgA抗体检测，对782例EB病毒抗体阳性体检者，进一步采用鼻咽CT影像检查、电子鼻咽镜检查，最后通过病理活检及免疫组化进行确诊。比较血清学检查结果中EB抗体单项阳性、两项抗体同时阳性和三项抗体同时阳性的鼻咽癌检出率，评价EB病毒抗体联合检测在鼻咽癌高危人群筛查中的应用价值。结果17175例体检人群中，共检出EB病毒抗体阳性782例，以单项阳性最多，占535例（68．41％），确诊鼻咽癌15例（2．80％）；两项抗体同时阳性213例（27．24％），确诊鼻咽癌49例（23．00％）；三项抗体同时阳性最少，仅有34例（4．35％），确诊鼻咽癌18例（52．94％）；通过体格检查，在16393例EB病毒抗体阴性人群中通过鼻咽镜和咽部CT等体格检查，最后确诊鼻咽癌6例（0．04％）。结论联合检N--项EB病毒抗体大大提高鼻咽癌诊断率；同时，也要做好其它体格检查，防止EB病毒抗体阴性鼻咽癌人群漏诊。

Objective To study the relationship between nasopharyngeal carcinoma and positive IgA antibodies of EB virus nuclear antigen 1 （ NA）, EB virus capsular antigen （VCA） and EB virus Zta protein. Methods The serum EB virus VCA -IgA, NA1 -IgA and Zta- IgA antibody in 17 175 cases were detected by ELISA. 782 cases of EB virus antibody - positive subjects were further given nasopharyngeal CT imaging, electronic nasopharyngoscopy. Finally confirmed by biopsy and immunohistochemistry. Comparison of serology results EB antibody - positive individual, while the two antibody - positive and antibody while three positive nasopharyngeal carcinoma detection rate, combined with evaluation of EB virus antibody detection in nasopharyngeal carcinoma screening value of high - risk groups. Results 17 175 cases of medical groups,the EB virus antibodies were detected in 752 cases,with the most positive individual, accounting for 535 cases （ 68.41% ）, nasopharyngeal cancer diagnosed in 15 cases （ 2.80% ） ; two anti- body positive while 513 cases （27.24 % ） ,diagnosed 49 cases of nasopharyngeal carcinoma （23.00%） ;least three antibody positive while only 34 cases （4.35%）, nasopharyngeal cancer diagnosed 18 patients （52.94%） ;by physical examination,in 16,393 cases of EB virus antibody negative population by nasopharyngoscopy and throat CT and other medical examination,the final diagnosis of nasopharyngeal carcinoma in 6 cases （0.04%）. Conclusion Three EB virus antibody combined detection greatly improves the rate of nasopharyngeal cancer diagnosis ; we must also do other physical examination to prevent EB virus antibody - negative nasopharyngeal crowd missed.