化学发光法检测EB病毒衣壳抗原IgA抗体(VCA-IgA)的最佳截断值(肇庆地区)及其在鼻咽癌诊断的价值

The best cut-off value for the test of EBV capsid antigen IgA antibody(VCA-IgA)by chemiluminescence method(In Zhaoqing City)and its value in the diagnosis of nasopharyngeal carcinoma

目的:本研究旨在探究EB病毒衣壳抗原IgA(VCA-IgA)抗体化学发光法在鼻咽癌高发区(肇庆地区)的最佳截断值.方法:收集2019年1月-2021年12月肇庆市第一人民医院的鼻咽癌患者和正常人血清1583例.根据临床诊断将病例分为正常对照组、鼻咽癌组、鼻咽良性疾病组和其他肿瘤组.采用回顾性分析方法,分别比较不同性别、年龄及组间血清VCA-IgA抗体的水平.并通过绘制ROC曲线,分析EB病毒衣壳抗原IgA(VCA-IgA)抗体化学发光法在肇庆地区的最佳截断值.结果:鼻咽癌患者VCA-IgA水平显著高于正常人组、鼻咽良性疾病组和其他肿瘤组(P<0.05);在正常人群中,男性VCA-IgA水平显著高于女性(P<0.05),年龄大于40岁的人群中,男性的鼻咽癌患病率显著大于女性(p<0.05);VCA-IgA水平随年龄增长而升高,且男性患病率与年龄成正相关(P<0.05);鼻咽癌各分期之间的VCA-IgA水平比较无显著差异;当截断值为4AU/mL时,其诊断的灵敏度为82.35%,特异性为80.96%,当截断值为4.42 AU/ml时,约登指数最大,其诊断的灵敏度为82.35%,特异性为83.12%.结论:NPC患者血清VCA-IgA水平明显升高,VCA-IgA是诊断鼻咽癌的良好指标;肇庆地区大于40岁的中老年男性是鼻咽癌高危人群,应对这类VCA-IgA阳性人群重点关注,增加随访频次.4.42AU/mL应作为肇庆地区VCA-IgA新的截断值,这将提高其对于鼻咽癌的诊断效能.

Objective:This study was to investigate the best cut-off value of EB virus capsid antigen antibody IgA(VCA-IgA)using the chemiluminescence method in Zhaoqing City,which is regarded as a high nasopharyngeal carcinoma incidence area.Methods:Serum samples from 1583 nasopharyngeal carcinoma patients and normal controls were collected from The First People's Hospital of Zhaoqing City from January 2019 to December 2021.the patients were divided into a normal control group,a nasopharyngeal carcinoma group,a nasopharyngeal benign disease group and another tumor group based on their clinical diagnosis.By drawing the ROC curve,the serum VCA-IgA antibody levels of different genders,ages and groups were compared retrospectively.Then the best cut-off value of EB virus capsid-antigen IgA antibody(VCA-IgA)in Zhaoqing was analyzed using the chemiluminescence method.Results:The level of VCAIgA in nasopharyngeal carcinoma patients was significantly higher than that in the normal control group,nasopharyngeal benign disease group and other tumor groups(P<0.05).In the normal sample population,the level ofVCA-IgA in males was significantly higher than that in females(P<0.05),and the incidence of nasopharyngeal carcinoma in men aged over 40 was significantly higher than that in women(P<0.05).There was no significant difference in VCA-IgA level among different stages of nasopharyngeal carcinoma.When the cut-off value was 4 AU/mL,the diagnostic sensitivity and specificity were 82.35%and 80.96%,while when the cut-off value was 4.42 AU/mL,the Youden index was the largest,the diagnostic sensitivity and specificity were 82.35%and 83.12%respectively.Conclusion:The serum VCA-IgA level in NPC patients is significantly increased,which indicates that VCA-IgA is a good indicator for the diagnosis of nasopharyngeal carcinoma.Middle-aged and elderly men over 40 years old in Zhaoqing are susceptible populations for nasopharyngeal cancer,who deserve more attention and follow-up visit frequency.The exact figure of 4.42 AU/mL should be used as a new cut-off value for VCA-IgA in Zhaoqing City,which will improve diagnostic efficacy for nasopharyngeal carcinoma.