血清EB-VCA-IgA、EA-D-IgA及EA-D-IgG抗体对鼻咽癌诊断的意义

Significance of serum EB-VCA-IgA,EA-D-IgA and EA-D-IgG antibodies in the diagnosis of nasopharyngeal carcinoma

目的探讨鼻咽癌患者血清EB病毒壳抗原免疫球蛋白A(VCA-IgA)、EB病毒早期抗原-D-IgA抗体(EA-D-IgA)、EA-D-IgG联合检测对于鼻咽癌患者诊断的价值。方法选取60例经病理学确诊的鼻咽癌患者(鼻咽癌组)及60例良性鼻咽疾病患者(良性组),采用酶联免疫吸附法(ELISA)检测血清VCA-IgA、EA-D-IgA、EA-D-IgG,对比两组患者的检出阳性率,并计算相关诊断学效能指标。结果鼻咽癌组血清VCA-IgA、EA-DIgA、EA-D-IgG抗体阳性率分别为81.67%、50.00%、83.33%,均显著高于良性组的10.00%、5.00%、3.33%,差异均具有统计学意义(P﹤0.01);血清VCA-IgA鉴别诊断鼻咽癌的灵敏度为81.67%,特异度为86.67%;EA-D-IgA鉴别诊断鼻咽癌的灵敏度为48.33%,特异度为91.67%;EA-D-IgG鉴别诊断鼻咽癌的灵敏度为83.33%,特异度为88.33%;血清VCA-IgA+EA-D-IgA+EA-D-IgG鉴别诊断鼻咽癌的灵敏度为95.00%,特异度为96.67%。结论鼻咽癌患者血清VCA-IgA+EA-D-IgA+EA-D-IgG联合检测对于提高鼻咽癌诊断具有更高的临床价值。

Objective To investigate the significance of combined detection of serum EB virus capsid antigen immunoglobulin A（VCA-IgA）, EB virus early antigen-D-IgA antibody（EA-D-IgA） and EA-D-IgG in the diagnosis of nasopharyngeal carcinoma（NPC）. Method A total of 60 cases of patients with pathologically confirmed nasopharyngeal carcinoma（NPC group）, and another 60 cases of benign nasopharyngeal diseases（benign group） were included in the study,enzyme-linked immunosorbent assay（ELISA） detection was utilized to detect the serum VCA- IgA, EA- D- IgA, EA- DIgG, and positive rates in the two groups of patients were compared, and relevant diagnostic effectiveness indexes were calculated. Result The serum VCA- IgA, EA- D- IgA, EA- D- IgG antibody positive rates were 81.67%, 50.00% and83.33% in NPC group, and were significantly higher than that in benign group at 10.00%, 5.00%, and 3.33%, with significant differences observed（P〈0.01）; the sensitivity of serum VCA-IgA in differential diagnosis of NPC was 81.67%, and the specificity was 86.67%; while those for EA-D-IgA were 48.33% and 91.67%, and were 83.33% and 88.33% for EAD-IgG, respectively; besides, the sensitivity of serum VCA-IgA＋EA-D-IgA＋EA-D-IgG in differential diagnosis of NPC was 95.00%, with specificity being 96.67%. Conclusion The combined detection of serum VCA-IgA＋EA-D-IgA＋EAD-IgG is of higher clinical significance in the diagnosis of nasopharyngeal carcinoma.