鼻咽癌(NPC)早期发现中的Epstein-Barr病毒脱氧核糖核酸酶抗体血清学研究

SEROLOGICAL STUDY OF ANTIBODIES AGAINST EPSTEIN-BARR VIRUS SPECIFIC DNaes(EDAb) AS A METHOD FOR EARLY DETECTION OF NASOPHARYNGEAL CARCINOMA (NPC)

血清Epstein-Barr病毒脱氧核糖核酸酶抗体(EDAb)检测对鼻咽癌(NPC)早期发现有较高的特异性及灵敏度。由于原检测方法重复性未够理想等原因,目前国际上仍未有一套较完整的EDAb血清学数据。通过进一步研究,作者发现国际上沿用的EDAb滴度单位——酶中和单位/毫升血清随着工作酶用量增加而呈线性上升,而作者首次提出的滴度单位——抗酶率(AER)则在一定酶活性范围内为一常数,其大小决定于被测血清EDAb滴度高低,因而提高检测结果的准确性。以上述技术为基础,作者报告对广东省四会县30～59岁正常人2060例,中山医科大学附属肿瘤医院收集的NPC患者430例,以及其他癌瘤患者204例EDAb检测结果。

The EDAb titers are a tumor marker for detecting NPC with high sensitivity and specifieity, but were not ideal in their reproducibility for examination. Until now, no systematic EDAb data and EDAb titer distribution in the general population have appeared in the literature. It has been found by the authors that the EDAb unit (conventional enzyme neutralized unit) showed a linear elevation with the increase of the EBV-DNase activity used. In order to raise the accuracy of the EDAb determination, we first used the Anti-enzyme rate (AER) as the EDAb unit since this value corresponded well with the EDAb titre in the serum tested. With these technics we have established, 3 475 serum samples were examined. It was found that the AER of NPC patients gave a negative skewness distribution and the Md = 65.3%, while normal persons gave a serious postive skewness distribution and the Md = 7.9%. According to the pattern of the EDAb distribution curve of NPC patients and normal persons an AER value of ≥ 30% was defined as a cut-off point between EDAb positive and negative. By this criteria, 90.7% (390/430) of NPC patients were shown to be positive for EDAb, while only 3.3% (68/2060) were positive in normal persons. Similarly a low positive rate (3.4%, 7/204) was found in the other tumors including those of the head and neck.