血清EB病毒抗体EA-IgA、VCA-IgA和Rta-IgG联合检测在鼻咽癌诊断中的意义

Diagnostic significance of combined detection of Epstein-Barr virus antibodies,EA-IgA,VCA-IgA and Rta-IgG in serum for nasopharyngeal carcinoma

目的探讨血清EB病毒EA-IgA抗体、VCA-IgA抗体和Rta-IgG抗体联合检测在鼻咽癌早期筛查和诊断中的临床价值。方法收集2019年初次就诊的264例鼻咽癌患者和264例健康体检者血清样本及其临床资料,采用酶联免疫吸附法(ELISA)检测血清中EA-IgA、VCA-IgA和Rta-IgG抗体水平,并评价各项指标在鼻咽癌诊断中的价值。结果EA-IgA、VCA-IgA和Rta-IgG抗体单独诊断鼻咽癌的灵敏度分别为57.20%、47.35%、75.38%;特异度分别为98.11%、97.35%、96.21%。其中Rta-IgG抗体的灵敏度最高,特异性较好。初诊鼻咽癌组三种抗体的血清学水平或阳性率均显著高于健康对照组,差异均有统计学意义(P<0.05)。在联合检测诊断鼻咽癌时,EA-IgA+VCA-IgA+Rta-IgG抗体三项联合的灵敏度最高,为92.05%;AUC面积最大,为0.946;阴性预测值最高,为92.02%;漏检率最低,为7.95%;特异度好,为91.67%。EA-IgA、VCA-IgA和Rta-IgG抗体阳性率与性别、年龄、临床分期和TNM分期均无明显相关性(P>0.05)。结论EA-IgA+VCA-IgA+Rta-IgG抗体三项联合检测对于鼻咽癌早期筛查及诊断具有更高的临床价值。

Objective To explore the clinical value of combined detection of Epstein-Barr virus antibodies,EA-IgA,VCA-IgA,and Rta-IgG in serum in the early screening and serodiagnosis of nasopharyngeal carcinoma(NPC).Methods We collected serum samples and clinical data from 264 NPC patients at first-time consultancy and 264 health examinees in 2019.Enzyme-linked immunosorbent assay(ELISA)was used to determine the levels of serum EA-IgA,VCA-IgA and Rta-IgG antibodies,and the values of the above-mentioned indicators in the diagnosis of NPC were evaluated.Results The sensitivity and specificity of EA-IgA,VCA-IgA and Rta-IgG antibodies in the diagnosis of NPC while detecting solely were 57.20%and 98.11%,47.35%and 97.35%,75.38%and 96.21%,respectively.Among them,the sensitivity of Rta-IgG antibody was the highest,and its specificity was better.The serological levels or positive rates of the three antibodies in the newly-diagnosed NPC group were significantly higher than those in the healthy control group,showing statistically significant differences(all P<0.05).In the combined detection and diagnosis of NPC,the sensitivity of combinations of EA-IgA+VCA-IgA+Rta-IgG antibodies was the highest(92.05%),with the largest AUC area(0.946),the highest negative predictive value(92.02%),the lowest omission rate(7.95%)and better specificity(91.67%).The positive rates of EA-IgA,VCA-IgA and Rta-IgG antibodies had no significant correlation with gender,age,clinical stage and tumor-node-metastasis(TNM)stage(all P>0.05).Conclusions The combined detection of EA-IgA+VCA-IgA+Rta-IgG antibodies has higher clinical value for early screening and diagnosis of NPC.