中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
44期
3516-3519
,共4页
罗耀凌%陈浩%彭颂国%林建华%黄培钰
囉耀凌%陳浩%彭頌國%林建華%黃培鈺
라요릉%진호%팽송국%림건화%황배옥
疱疹病毒4型,人%鼻咽肿瘤%血清学试验%DNA,病毒
皰疹病毒4型,人%鼻嚥腫瘤%血清學試驗%DNA,病毒
포진병독4형,인%비인종류%혈청학시험%DNA,병독
Herpesvirus 4,human%Nasopharyngeal neoplasms%Serologic tests%DNA,viral
目的 同时检测EB病毒(EBV) Rta-IgG、衣壳抗原(VCA)-IgA、早期抗原(EA)-IgA、EBV-DNA,评价EBV血清学联合检测在鼻咽癌诊断中的价值.方法 收集2012年1-12月中山大学肿瘤防治中心经病理确诊的131例治疗前鼻咽癌、52例非鼻咽癌的相似症状患者和148名健康体检者的血清和血浆,应用免疫酶染色法检测血清VCA-IgA、EA-IgA抗体;ELISA法检测Rta-IgG抗体;用实时荧光定量PCR分析血浆EBV-DNA.比较单独应用和联合应用各指标在鼻咽癌血清学诊断中的敏感度和特异度.结果 鼻咽癌组Rta-IgG、VCA-IgA、EA-IgA、EBV-DNA阳性率均高于鼻咽相关疾病组及健康对照组(均P＜0.01).Rta-IgG、EBV-DNA阳性率及EBV-DNA水平随鼻咽癌临床分期增高而增高(均P ＜0.05);VCA-IgA、EA-IgA阳性率与鼻咽癌临床分期无关(P＞0.05).Rta-IgG和EBV-DNA的受试者工作特征曲线下面积分别为0.901和0.827,4个指标对鼻咽癌血清学诊断效能均较好,单项检测的敏感度和特异度分别为:Rta-IgG:77.9％ 、92.5％,VCA-IgA:93.1％、91.5％,EA-IgA:74.8％、99.5％,EBV-DNA:64.9％、97.0％;联合检测的敏感度和特异度分别为97.7％、83.5％.结论 联合检测Rta-IgG、VCA-IgA、EA-IgA、EBV-DNA可提高EBV血清学在鼻咽癌诊断中的效益.
目的 同時檢測EB病毒(EBV) Rta-IgG、衣殼抗原(VCA)-IgA、早期抗原(EA)-IgA、EBV-DNA,評價EBV血清學聯閤檢測在鼻嚥癌診斷中的價值.方法 收集2012年1-12月中山大學腫瘤防治中心經病理確診的131例治療前鼻嚥癌、52例非鼻嚥癌的相似癥狀患者和148名健康體檢者的血清和血漿,應用免疫酶染色法檢測血清VCA-IgA、EA-IgA抗體;ELISA法檢測Rta-IgG抗體;用實時熒光定量PCR分析血漿EBV-DNA.比較單獨應用和聯閤應用各指標在鼻嚥癌血清學診斷中的敏感度和特異度.結果 鼻嚥癌組Rta-IgG、VCA-IgA、EA-IgA、EBV-DNA暘性率均高于鼻嚥相關疾病組及健康對照組(均P＜0.01).Rta-IgG、EBV-DNA暘性率及EBV-DNA水平隨鼻嚥癌臨床分期增高而增高(均P ＜0.05);VCA-IgA、EA-IgA暘性率與鼻嚥癌臨床分期無關(P＞0.05).Rta-IgG和EBV-DNA的受試者工作特徵麯線下麵積分彆為0.901和0.827,4箇指標對鼻嚥癌血清學診斷效能均較好,單項檢測的敏感度和特異度分彆為:Rta-IgG:77.9％ 、92.5％,VCA-IgA:93.1％、91.5％,EA-IgA:74.8％、99.5％,EBV-DNA:64.9％、97.0％;聯閤檢測的敏感度和特異度分彆為97.7％、83.5％.結論 聯閤檢測Rta-IgG、VCA-IgA、EA-IgA、EBV-DNA可提高EBV血清學在鼻嚥癌診斷中的效益.
목적 동시검측EB병독(EBV) Rta-IgG、의각항원(VCA)-IgA、조기항원(EA)-IgA、EBV-DNA,평개EBV혈청학연합검측재비인암진단중적개치.방법 수집2012년1-12월중산대학종류방치중심경병리학진적131례치료전비인암、52례비비인암적상사증상환자화148명건강체검자적혈청화혈장,응용면역매염색법검측혈청VCA-IgA、EA-IgA항체;ELISA법검측Rta-IgG항체;용실시형광정량PCR분석혈장EBV-DNA.비교단독응용화연합응용각지표재비인암혈청학진단중적민감도화특이도.결과 비인암조Rta-IgG、VCA-IgA、EA-IgA、EBV-DNA양성솔균고우비인상관질병조급건강대조조(균P＜0.01).Rta-IgG、EBV-DNA양성솔급EBV-DNA수평수비인암림상분기증고이증고(균P ＜0.05);VCA-IgA、EA-IgA양성솔여비인암림상분기무관(P＞0.05).Rta-IgG화EBV-DNA적수시자공작특정곡선하면적분별위0.901화0.827,4개지표대비인암혈청학진단효능균교호,단항검측적민감도화특이도분별위:Rta-IgG:77.9％ 、92.5％,VCA-IgA:93.1％、91.5％,EA-IgA:74.8％、99.5％,EBV-DNA:64.9％、97.0％;연합검측적민감도화특이도분별위97.7％、83.5％.결론 연합검측Rta-IgG、VCA-IgA、EA-IgA、EBV-DNA가제고EBV혈청학재비인암진단중적효익.
Objective To evaluate the values of combined detection method of EB viral Rta-IgG,VCA-IgA,EA-IgA and EB viral DNA in the diagnosis of nasopharyngeal carcinoma (NPC).Methods Serum and plasma samples from 131 untreated NPC patients,52 non-NPC patients with NPC-like symptoms and 148 healthy donors from January to December 2012 were collected.Immunoenzymatic staining was used to detect VCA-IgA and EA-IgA in sera.ELISA was performed to detect Rta-IgG antibody in sera and realtime fluorescent quantitative PCR for measuring EBV DNA in plasma.The clinical characteristics of 3 groups were compared.ROC curve and correlation analyses were performed to assess the detection assays for the diagnosis of NPC.Results The positive rates of EBV Rta-IgG,VCA-IgA,EA-IgA and EBV DNA in untreated NPC patient group were higher than those in other two groups.The differences were statistically significant (all P ＜0.01).The differences of Rta-IgG antibody positive rates,EBV-DNA levels and EBV-DNA positive rates at different clinical stages were statistically significant (all P ＜ 0.05).The positive rates of VCA-IgA and EA-IgA were not related with clinical stages (P ＞ 0.05).Areas under ROC curve for RtaIgG and EBV-DNA were 0.901 and 0.827 respectively.All four diagnostic assays demonstrated excellent efficiency.The sensitivity and specificity of individual assays were as follows:Rta-IgG:77.9％,92.5％ ;VCA-IgA 93.1％,91.5％ ; EA-IgA:74.8％,99.5％ ; EBV-DNA 64.9％,97.0％.The sensitivity and specificity of combined assays were 97.7％ and 83.5％ respectively.Conclusion Combined detection method of EB viral Rta-IgG,VCA-IgA,EA-IgA and EB viral DNA are efficient for the diagnosis of NPC.
