以血清EB病毒抗体谱评估患鼻咽癌危险度的研究

Assessment of nasopharyngeal carcinoma risk by EB virus antibody profile

目的 比较鼻咽癌患者与健康人群血清EB病毒抗体水平 ,评估患鼻咽癌的危险度。方法 收集珠江口地区 12 1例鼻咽癌患者和 332例健康人血清。采用酶联吸附试验 (ELISA)检测血清中EBNA 1 IgA、EBNA 1 IgG和zta IgG ,以免疫酶法或免疫荧光法检测VCA IgA。结果 EBNA 1 IgA、EBNA 1 IgG和zta IgG的敏感度分别为 85 %、83%和 79% ;三者组合的敏感度最高 ,为 92 %。EBNA 1 IgA、EBNA 1 IgG和zta IgG的特异度分别为 86 %、86 %和 80 % ;三者组合的特异度最高 ,为 93%。根据优势比水平 ,可将患鼻咽癌的危险度分为低危险、中危险和高危险 3个层次。 93%的健康人是低危险的 ,优势比为 0 .0～ 0 .3;0 .4 %的健康人是高危险的 ,优势比为 137.9。结论 ELISA在诊断鼻咽癌的结果判断上更具客观性 ,较传统免疫酶法好 ;EBNA 1 IgA、EBNA 1 IgG和zta IgG的联合应用可以评估人群患鼻咽癌的危险度。

Objective To evaluate the risk of nasopharyngeal carcinoma (NPC) through EB virus antibody profile by enzyme linked immunosorbent assay (ELISA).Methods EBNA 1/IgA, EBNA 1/IgG and zta/IgG by ELISA and VCA/IgA by immmunoenzymatic method were detected in 121 NPC patients and 332 healthy subjects (HS) in the Pearl river estuary. Results The sensitivity rates were 85%, 83% and 79% for EBNA 1/IgA, EBNA 1/IgG and zta/IgG, all three of which if combined was the highest 92%. The specificity rates were 86%, 86% and 80% for EBNA 1/IgA, EBNA 1/IgG and zta/IgG, all three of which if combined was also the highest 93%. According to the level of odds ratio, nasopharyngeal carcinoma risk could be divided into 3 groups: low, moderate and high-risk groups. 93% of HS had low risk of NPC with the odds ratio 0.0 to 0.3. 0.4% of HS had high risk of NPC with the odds ratio of 137.9%. Conclusion ELISA is more objective than the traditional immunoenzymatic method in the detection and diagnosis of NPC. The combination of EBNA 1/IgA, EBNA 1/IgG and zta/IgG is able to evaluate the risk of NPC.