Karray H, Ayadi W, Fki L, Hammami A, Daoud J, Drira M M, Frikha M, Jlidi R, Middeldorp J M
Department of Microbiology, Faculty of Medicine, University Habib Bourguiba, Sfax, Tunisia.
J Med Virol. 2005 Apr;75(4):593-602. doi: 10.1002/jmv.20310.
Nasopharyngeal carcinoma (NPC) in Tunisia is characterized by its bimodal age distribution involving juvenile patients of 10-24 years and adult patients of 40-60 years. Three serological techniques were compared for primary diagnosis (N = 117) and post-treatment monitoring (N = 21) of NPC patients separated in two age groups. Immunofluorescence assay (IFA) was used as the "gold standard" for detection of IgG and IgA antibodies reactive with Epstein-Barr virus (EBV) early (EA) and viral capsid (VCA) antigens. Results were compared with ELISA measuring IgG and IgA antibody reactivity to defined EBNA1, EA, and VCA antigens. Immunoblot was used to reveal the molecular diversity underlying the anti-EBV IgG and IgA antibody responses. The results indicate that young NPC patients have significantly more restricted anti-EBV IgG and IgA antibody responses with aberrant IgG VCA/EA levels in 78% compared to 91.7% in elder patients. IgA VCA/EA was detected in 50% of young patients versus 89.4% for the elder group (P < 0.001). Immunoblot revealed a reduced overall diversity of EBV antigen recognition for both IgG and IgA in young patients. A good concordance was observed between ELISA and IFA for primary NPC diagnosis with 81-91% overall agreement. Even better agreement (95-100%) was found for antibody changes during follow-up monitoring, showing declining reactivity in patients in remission and increasing reactivity in patients with persistent disease or relapse. ELISA for IgA anti-VCA-p18 and immunoblot proved most sensitive for predicting tumor relapse. VCA-p18 IgA ELISA seems suitable for routine diagnosis and early detection of NPC complication.
突尼斯的鼻咽癌（NPC）具有双峰年龄分布特征，涉及10至24岁的青少年患者和40至60岁的成年患者。对117例原发性诊断和21例接受治疗后的监测患者进行了三种血清学技术比较，这些患者被分为两个年龄组。免疫荧光测定法（IFA）被用作检测与爱泼斯坦-巴尔病毒（EBV）早期抗原（EA）和病毒衣壳抗原（VCA）反应的IgG和IgA抗体的“金标准”。将结果与检测针对确定的EBNA1、EA和VCA抗原的IgG和IgA抗体反应性的ELISA进行比较。免疫印迹法用于揭示抗EBV IgG和IgA抗体反应背后的分子多样性。结果表明，年轻的NPC患者抗EBV IgG和IgA抗体反应明显更受限，78%的患者IgG VCA/EA水平异常，而老年患者为91.7%。50%的年轻患者检测到IgA VCA/EA，而老年组为89.4%（P<0.001）。免疫印迹显示年轻患者中EBV抗原识别的总体多样性降低。在NPC原发性诊断中，ELISA和IFA之间观察到良好的一致性，总体一致性为81-91%。在随访监测期间抗体变化方面发现了更好的一致性（95-100%），显示缓解患者的反应性下降，持续疾病或复发患者的反应性增加。IgA抗VCA-p18的ELISA和免疫印迹法在预测肿瘤复发方面最敏感。VCA-p18 IgA ELISA似乎适用于NPC并发症的常规诊断和早期检测。
