鼻咽癌围放疗期EB病毒IgA抗体水平变化的价值研究

The clinical value of changes of EB virus IgA antibody levels in patients with nasopharyngeal carcinoma patients during radiotherapy

目的研究鼻咽癌围放疗期EB病毒免疫球蛋白A(IgA)抗体水平变化价值,为临床诊治提供参考。方法选自2014年4月至2017年3月收治的鼻咽癌患者61例;另选自同期收治的50例EBV血清学检测正常的健康者作为对照组。空腹采集外周静脉血,分离血清,采用ELISA法测定衣壳抗原IgA(VCA-IgA)和早期抗原IgA(EA-IgA)水平。比较2组VCA-IgA和EA-IgA抗体水平,鼻咽癌患者放疗前后VCA-IgA和EA-IgA抗体水平和阳性率,及EA-IgA和VCA-IgA联合诊断特异度及灵敏度。结果对照组受试者EA-IgA及VCA-IgA抗体水平明显低于试验组,差异有统计学意义(P<0.05);鼻咽癌患者放疗后与放疗前比较, EA-IgA及VCA-IgA降低明显,差异有统计学意义(P<0.05);鼻咽癌患者放疗后与放疗前比较,EA-IgA及VCA-IgA阳性率降低明显,差异有统计学意义(P<0.05);鼻咽癌患者EA-IgA及VCA-IgA单项诊断的特异度及灵敏度均低于联合诊断。结论鼻咽癌患者EA-IgA及VCA-IgA水平明显升高,且两者若联合诊断,其特异度及灵敏度均优于单项诊断,值得在临床上推广。

Objective To investigate the clinical value of changes of EB immunoglobulin A (IgA) antibody levels in nasopharyngeal carcinoma (NPC) during radiotherapy. Methods A total of 61 patients with nasopharyngeal carcinoma who were admitted and treated in our hospital from April 2014 to March 2017 were enrolled as observation group, at the same time, the other 50 healthy subjects who underwent EBV serological tests were enrolled as control group. The fasting peripheral blood specimens were collected . The levels of capsid antigen IgA (VCA-IgA) and early antigen IgA (EA-IgA) were detected by ELISA. The levels of VCA-IgA and EA-IgA antibodies were observed and compared between the two groups.Moreover the levels and positive rates of VCA-IgA and EA-IgA antibodies before and after radiotherapy as well as the sensitivity and specificity of VCA-IgA and EA-IgA in combination diagnosis of NPC in observation group were analyzed. Results The levels of VCA-IgA and EA-IgA antibody in control group were significantly higher than those in observation group ( P <0.05).There were significant differences in the levels of VCA-IgA and EA-IgA antibody in observation group before radiotherapy and after radiotherapy ( P <0.05),moreover,the positive rates of VCA-IgA and EA-IgA in observation group after radiotherapy were significantly lower than those before radiotherapy ( P <0.05).In addition the sensitivity and specificity of simple VCA-IgA test or simple EA-IgA test in diagnosis of NPC were lower than those by combination detection of VCA-IgA and EA-IgA. Conclusion The levels of VCA-IgA and EA-IgA are increased in patients with NPC, moreover, the sensitivity and specificity of combination detection of VCA-IgA and EA-IgA in diagnosis of NPC are superior to those by simple VCA-IgA test or simple EA-IgA test,therefore, which is worthy of clinical application and promotion.