标题：鼻咽癌患者血清EB病毒抗体表达及诊断价值研究

      作者：陈珊，刘健，姚艺雄    肇庆市第一人民医院检验科，广东 肇庆 526020

      卷次： 2020年31卷2期

      【摘要】 目的 探讨鼻咽癌患者血清EB病毒抗体表达及诊断价值，为患者临床诊疗提供依据。方法 选取2017年6月至2019年6月肇庆市第一人民医院收治的60例确诊为鼻咽癌患者为研究组，选取同期就诊的60例鼻咽部良性疾病患者为对照组。采用酶联免疫吸附试验(ELISA)检测两组患者血清EB病毒的VCA-IgA、EA-IgA及EA-IgG抗体表达水平，比较两组患者血清EB病毒抗体检测阳性率，并采用受试者工作特征曲线(ROC)分析3种EB病毒抗体对鼻咽癌患者的诊断价值。结果 研究组患者血清EB病毒VCA-IgA、EA-IgA及EA-IgG抗体检测阳性率分别为 93.33%、53.33%、73.33%，明显高于对照组的 18.33%、3.33%、6.67%，差异均有统计学意义(P<0.05)；VCA-IgA、EA-IgA、EA-IgG及其联合检测的ROC曲线下面积(AUC)分别为 0.698、0.514、0.685、0.943；VCA-IgA诊断鼻咽癌患者的灵敏度、特异度、准确度、阳性检测值和阴性检测值为 92.91%、86.51%、90.03%、35.83%、99.30%；EA-IgA诊断鼻咽癌患者的灵敏度、特异度、准确度、阳性检测值和阴性检测值为67.62%、95.82%、94.26%、48.48%、96.77%；EA-IgG诊断鼻咽癌患者的灵敏度、特异度、准确度、阳性检测值和阴性检测值为84.35%、93.43%、92.51%、43.27%、98.75%；3种EB病毒抗体联合诊断对鼻咽癌患者的灵敏度、特异度、阳性检测值和阴性检测值分别为95.31%、97.62%、98.59%、82.64%、99.57%，均明显高于VCA-IgA、EA-IgA、EA-IgG单独诊断，差异均有统计学意义(P<0.05)。结论 与鼻咽部良性疾病比较，鼻咽癌患者血清EB病毒VCA-IgA、EA-IgA及EA-IgG抗体检测阳性率均较高，EB病毒的三种抗体可以有效筛查鼻咽癌，而三种EB病毒抗体联合诊断可以有效提高患者诊断的灵敏度、特异度和准确度。
      【关键词】 鼻咽癌；血清；EB病毒；抗体；诊断价值
      【中图分类号】 R739.63 【文献标识码】 A 【文章编号】 1003—6350（2020）02—0175—03

Expression and diagnostic value of EB virus antibodies in patients with nasopharyngeal carcinoma.
CHEN Shan,LIU Jian, YAO Yi-xiong. Department of Laboratory, Zhaoqing First People's Hospital, Zhaoqing 526020, Guangdong,CHINA
【Abstract】 Objective To investigate the expression and diagnostic value of Epstein-Barr (EB) virus antibod-ies in patients with nasopharyngeal carcinoma, and provide evidence for clinical diagnosis and treatment of patients.Methods A total of 60 patients diagnosed with nasopharyngeal carcinoma admitted in Zhaoqing First People's Hospi-tal from June 2017 to June 2019 were selected as the study group, and 60 patients with benign nasopharynx disease treat-ed during the same period were selected as the control group. The levels of serum EB virus antibodies (VCA-IgA,EA-IgA, and EA-IgG) were detected by enzyme-linked immunosorbent assay (ELISA). The positive rates of serum EBvirus antibody detection were compared between the two groups, and the diagnostic value of three EB virus antibodies inpatients with nasopharyngeal carcinoma was analyzed by receiver operating characteristic curve (ROC). Results Thepositive rates of VCA-IgA, EA-IgA, and EA-IgG in the study group were 93.33%, 53.33%, and 73.33%, which were sig-nificantly higher than 18.33%, 3.33%, and 6.67% the control group (P<0.05); the area under the ROC curve (AUC) ofVCA-IgA, EA-IgA, EA-IgG and their combined detection were 0.698, 0.514, 0.685, 0.943; the sensitivity, specificity, ac-curacy, positive detection value, and negative detection value in the diagnosis of nasopharyngeal carcinoma were92.91%, 86.51%, 90.03%, 35.83%, and 99.30% for VCA-IgA; 67.62%, 95.82%, 94.26%, 48.48%, 96.77% for EA-IgA;84.35%, 93.43%, 92.51%, 43.27%, and 98.75% for EA-IgG; 95.31%, 97.62%, 98.59%, 82.64%, and 99.57% for com-bined diagnosis. The indexes of combined diagnosis were significantly higher than those of VCA-IgA, EA-IgA, andEA-IgG alone (P<0.05). Conclusion Compared with benign diseases of nasopharynx, EB virus antibodies VCA-IgA,EA-IgA, and EA-IgG in nasopharyngeal cancer patients have a higher positive detection rate. Combined detection of thethree antibodies can effectively screen nasopharyngeal cancer, which can effectively improve the sensitivity, specificityand accuracy of diagnosis as compared with each antibody alone.
      【Key words】 Nasopharyngeal carcinoma; Serum; Epstein-Barr virus; Antibody; Diagnostic value