【摘要】 目的探讨湖南地区EB病毒Rta蛋白抗体IgG(Rta-IgG)联合抗EB病毒衣壳抗原IgA(VCAIgA)和抗早期抗原IgA(EA-IgA)检测对鼻咽癌筛查和诊断的临床价值。方法收集经病理确诊为鼻咽癌的患者53例作为初诊鼻咽癌组;收集健康者213例作为健康对照组;收集已确诊鼻咽癌且经过治疗的患者104例作为治疗组。3组研究对象的血清标本均用ELISA定量检测血清中Rta-IgG、VCA-IgA和EA-IgA的抗体水平,并分析评价各指标在鼻咽癌诊断中的价值。结果 EB病毒Rta-IgG、VCA-IgA和EA-IgA抗体检测鼻咽癌诊断的灵敏度分别为81.13%、92.45%、75.47%,特异度分别为96.71%、96.24%、98.59%,阳性预测值分别为86.00%、85.96%、93.02%。Rta-IgG、VCA-IgA和EA-IgA 3项指标联合检测将鼻咽癌诊断的灵敏度和特异度提高至98.11%和100.00%,且均显著高于单一的各项抗体检测。3种抗体阳性率在鼻咽癌治疗组和初诊鼻咽癌组的变化差异无统计学意义(P>0.05)。3种抗体阳性率在各TNM分期及临床分期间差异均无统计学意义(P>0.05)。结论 VCA-IgA抗体对于湖南地区鼻咽癌的诊断效能相对最高,Rta-IgG、VCA-IgA和EA-IgA三者联合检测能进一步有效提高灵敏度、特异度及阳性预测值,对鼻咽癌的筛查和诊断有极大帮助。更多还原

【Abstract】 Objective To investigate the clinical value of EB virus Rta protein antibody(Rta-IgG)combined with VCA-IgA and EA-IgA detection in screening and diagnosis of nasopharyngeal carcinoma(NPC)in Hunan area.Methods Fifty-three cases of NPC definitely diagnosed by pathology were collected as the primary NPC group.Two hundreds and thirteen healthy people were collected as the healthy control group.One hundred and four patients with definitely diagnosed NPC and treatment were collected as the NPC treatment group.The enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum Rta-IgG,VCA-IgA and EA-IgA antibodies,and the value of each index in the diagnosis of NPC was analyzed.Results The sensitivities of EB virus Rta-IgG,VCA-IgA antibodies for detecting NPC were 81.13%,92.45% and75.47%respectively,the specificities were 96.71%,96.24% and 98.59% respectively,the positive predictive values were 86.00%,85.96%and 93.02%respectively.The sensitivity and specificity of the combined detection of Rta-IgG,VCA-IgA and EA-IgA in diagnosing NPC were increased to 98.11% and 100.00%respectively,which were significantly higher than the detection results of single antibody.The positive rate of the three antibodies had no significant difference between the NPC treatment group and non-treatment group(P>0.05).The positive rate of 3 kinds of antibodies had no difference between NPC treatment group and primary NPC group(P>0.05).Conclusion The efficiency of VCA-IgA antibody for diagnosing NPC in Hunan area is the highest,and the combined detection of Rta-IgG,VCA-IgA and EA-IgA can further effectively improve the sensitivity,specificity.and positive predictive value,which has the maximal help for the screening and diagnosis of NPC.更多还原