三种 EB 病毒相关抗体联合检测在 EB 病毒相关鼻咽癌诊断中的应用研究

Study on the application of three EB virus related antibodies in the diagnosis of EB virus associated nasopharyngeal carcinoma

目的：探讨 EB 病毒抗衣壳抗原 VCA-IgA 抗体、抗早期抗原 EA-IgA 抗体、抗立即早期抗原Rta-IgG 抗体联合检测在 EB 病毒相关鼻咽癌（NPC）诊断中的应用价值。方法收集47例未接受治疗的 NPC患者（NPC 组）、45例良性鼻炎患者（鼻炎组）和45例健康体检者（健康组）的血清标本，采用酶联免疫法测定血清中 VCA-IgA、EA-IgA 和 Rta-IgG 抗体的水平，以临床诊断为金标准，对比分析各指标单独及联合检测的灵敏性和特异性。结果鼻炎组血清 VCA-IgA、EA-IgA、Rta-IgG 的表达水平分别为（0．82±0．25）、（0．74±0.13）、（0．89±0．27），NPC 组分别为（2．16±0．39）、（1．26±0．24）、（3．95±0．76），健康组分别为（0．65±0.14）、（0．51±0．11）、（0．41±0．16），鼻炎组和 NPC 组患者血清 VCA-IgA、EA-IgA、Rta-IgG 的表达水平均显著高于健康组，其中 NPC 组表现尤为显著，组间差异有统计学意义（F ＝400．065、232．803、740．215，P ＝0.000、0．000、0．000）。不同 TNM分期 NPC 患者的 VCA-IgA、EA-IgA、Rta-IgG 的表达水平比较，差异均有统计学意义（F ＝195．679、30．878、38．561，P ＝0．000、0．000、0．000），随着病情的严重程度呈升高趋势。VCA-IgA的敏感度最高（85．11％），EA-IgA 的特异度最高（95．56％）；联合检测的敏感度均有所提高，其中三项联合检测的敏感度（95．74％）高于其他组合。结论VCA-IgA、EA-IgA 和 Rta-IgG 联合检测能够更大程度反映 EB 病毒相关抗原的表达，在 EB 相关 NPC 的诊断中优于单项或两项联合检测，具有较高的临床实用价值。

Objective To investigate the value of combined detection of viral capsid antibody（VCA -IgA）, early antigen antibody（EA -IgG）,and Rta protein antibody IgG（Rta -IgG）in the diagnosis of EB virus associated nasopharyngeal carcinoma（NPC）.Methods A total of 47 nasopharynx cancer patients,45 patients with benign rhinitis and 45 healthy controls were recruited.The serum levels of VCA -IgA,EA -IgA and Rta -IgG were tested by enzyme -linked immunosorbent assay （ELISA）.Specificity and sensitivity of the indicators alone and combined detection were compared using the clinical diagnosis as the gold standard.Results The expression levels of serum VCA -IgA,EA -IgA and Rta -IgG in the rhinitis group were （0.82 ±0.25）,（0.74 ±0.13）,（0.89 ±0.27）,the levels in the NPC group were （2.16 ±0.39）,（1.26 ±0.24）,（3.95 ±0.76）,and the levels in the healthy control group were （0.65 ±0.14）,（0.51 ±0.11）,（0.41 ±0.16）respectively.The levels of VCA -IgA,EA -IgA and Rta-IgG in the rhinitis group,NPC group and healthy group were significantly different （F =400.065,232.803, 740.215,P =0.000,0.000,0.000）.The levels of VCA -IgA,EA -IgA and Rta -IgG in the NPC patients with different TNMstages were significantly different（F =195.679,30.878,38.561,P =0.000,0.000,0.000）,and the trend of each antibody was increased with the severity of the disease.The sensitivity of VCA -IgA was the highest （85.11%）,and the specificity of EA -IgA was the highest（95.56%）.The sensitivity of the combined assay was 95.74%,which was higher than that of the other three combinations.Conclusion The combination of VCA -IgA, EA -IgA and Rta -IgG can reflect the expression of EBV -associated antigen to a greater extent,and it is superior to＆amp;nbsp;single or two combined detection in the diagnosis of EB -associated NPC,with a high clinical value.