【摘要】 目的:评价EB病毒特异性VCA-IgA和EA-IgA抗体定量检测对EB病毒相关的鼻咽癌的诊断意义。方法:试验组为228例鼻咽癌血清标本,对照组为102例正常健康体检者血清标本。用ELISA法定量检测血清标本中EBV特异性VCA-IgA和EA-IgA抗体水平,以临床病理诊断为金标准,分析各血清检测指标的准确性、灵敏性、特异性及其cut-off值的设定。结果:正常健康人血清中EB病毒特异性VCA-IgA和EA-IgA抗体的平均水平分别为15U/ml和11.5U/ml,鼻咽癌患者血清中VCA-IgA和EA-IgA抗体的平均水平分别为56.5U/ml和63.5U/ml,鼻咽癌组抗体水平显著高于健康体检组。根据VCA-IgA、EA-IgA定量检测结果绘制ROC曲线图,曲线下面积分别为0.903和0.948,VCA-IgA、EA-IgA定量检测可用于鼻咽癌的准确诊断。根据ROC曲线图分析,cut-off值分别设定为30U/ml和23U/ml。按此值设定时,VCA-IgA检测鼻咽癌的敏感性和特异性分别为84.9%和66.8%,EA-IgA检测鼻咽癌的敏感性和特异性分别为87.9%和91.1%。联合检测VCA-IgA和EA-IgA的敏感性为92%,特异性为91%。结论:以ELISA法定量检测VCA-IgA、EA-IgA的血清抗体水平对鼻咽癌具有诊断意义,尤其将两指标联合应用。更多还原

【Abstract】 Objective:To evaluate the diagnostic value of quantitative assay of EB virus specific antibodies to VCA-IgA and EA-IgA on diagnosing and screening of EB virus related nasopharyngeal carcinoma (NPC). Methods:The test panel consisted of 228 sera from NPC patients and 102 sera of healthy controls. For each specimen,immunoglobulin A antibodies to EBV-specific VCA(viral capsid antigen) and EA(early antigen) were quantitatively tested with enzyme linked immune absorbed assay respectively. Compared with the clinical pathologic diagnosis,the accuracy,sensitivity,specificity and cut-off value of each biomarker were analyzed. Results: The mean value of EB virus specific VCA-IgA and EA-IgA antibodies were 15 U/ mL and 11.5 U/ ml among healthy population;56.5 U/ ml and 63.5 U/ ml among NPC patients,each one’s level was significant higher in NPC patients than that in healthy population. VCA-IgA and EA-IgA can be used in diagnosing NPC accurately with 0.903 and 0.948,area under the ROC curve respectively. Through ROC curve analysis,the best cut-off values of VCA-IgA and EA-IgA were 30 U/mL and 23 U/ml. At this level,the sensitivity and specificity for diagnosing NPC were 84.9% and 66.8% for VCA-IgA,87.9% and 91.1% for EA-IgA,and 92% and 91% for combined determination. Conclusion:Quantitative detection of VCA-IgA and EA-IgA antibodies with ELISA method is very valuable in diagnosing NPC,especially combined determination.更多还原