Hao Sheng-Po, Tsang Ngan-Ming, Chang Kai-Ping, Ueng Shir-Hwa
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan, ROC.
Otolaryngol Head Neck Surg. 2004 Nov;131(5):651-4. doi: 10.1016/j.otohns.2004.04.013.
The aim of this study was to investigate the feasibility of molecular diagnosis of nasopharyngeal carcinoma (NPC) by combining nasopharyngeal swab and polymerase chain reaction (PCR) to detect Epstein-Barr virus (EBV) derived latent membrane protein-1 gene (LMP-1) and Epstein-Barr nuclear antigen gene (EBNA).
437 adults underwent nasopharyngoscopy, possible biopsy, and nasopharyngeal swab to obtain nasopharyngeal cells for the detection of LMP-1 and EBNA by PCR.
By detecting LMP-1 and EBNA in the nasopharyngeal swabs, NPC could be diagnosed with a false-positive rate of 1.7% (6/354), a false-negative rate of 8.6% (6/70), a sensitivity of 91.4% (64/70), a specificity of 98.3% (348/354), positive predictive value of 91.4% (64/70), and negative predictive value of 98.3% (348/354).
Detecting EBV genomic LMP-1 and EBNA by nasopharyngeal swab verifies NPC with a sensitivity of 91.4% and specificity of 98.3%. The nasopharyngeal swab coupled with PCR based EBV LMP-1 and EBNA detection could serve as a good supplement to pathological diagnosis of NPC.
本研究旨在探讨通过联合鼻咽拭子和聚合酶链反应（PCR）检测爱泼斯坦-巴尔病毒（EBV）衍生的潜伏膜蛋白-1基因（LMP-1）和爱泼斯坦-巴尔核抗原基因（EBNA）对鼻咽癌（NPC）进行分子诊断的可行性。
437名成年人接受了鼻咽镜检查、可能的活检和鼻咽拭子检查，以获取鼻咽细胞，通过PCR检测LMP-1和EBNA。
通过检测鼻咽拭子中的LMP-1和EBNA，诊断鼻咽癌的假阳性率为1.7%（6/354），假阴性率为8.6%（6/70），灵敏度为91.4%（64/70），特异度为98.3%（348/354），阳性预测值为91.4%（64/70），阴性预测值为98.3%（348/354）。
通过鼻咽拭子检测EBV基因组LMP-1和EBNA诊断鼻咽癌的灵敏度为91.4%，特异度为98.3%。鼻咽拭子联合基于PCR的EBV LMP-1和EBNA检测可作为鼻咽癌病理诊断的良好补充。
