Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China.
Chin Med J (Engl). 2010 May 5;123(9):1201-5.
Non-invasive nasopharyngeal carcinoma (NPC) screening usually involves serological testing for the presence of IgA antibodies to Epstein-Barr virus (EBV) capsid antigen (VCA). The present meta-analysis determined the accuracy of VCA-IgA in the diagnosis of NPC.
A systematic review of studies was conducted and data on the accuracy of VCA-IgA concentrations in the diagnosis of NPC were pooled using random effects models. Receiver operating characteristic curves were used to summarize the overall test performance.
Twenty studies met the inclusion criteria for the meta-analysis. The summary estimates for VCA-IgA in the diagnosis of NPC were: sensitivity 0.91 (95% confidence interval (CI): 0.90 - 0.92), specificity 0.92 (95%CI: 0.92 - 0.93), positive likelihood ratio 31.65 (95%CI: 10.99 - 91.15), negative likelihood ratio 0.10 (95%CI: 0.07 - 0.13) and diagnostic odds ratio 414.59 (95%CI: 174.96 - 982.42). The area under the summary receiver operating characteristic curves was 0.98.
The sensitivity and the specificity of serum VCA-IgA are very high, suggesting that the presence of VCA-IgA in peripheral blood is a valuable predictor for NPC.
鼻咽癌（NPC）的非侵入性筛查通常涉及检测针对 Epstein-Barr 病毒（EBV）衣壳抗原（VCA）的 IgA 抗体的血清学测试。本荟萃分析确定了 VCA-IgA 在 NPC 诊断中的准确性。
进行了系统的文献回顾，并使用随机效应模型汇总了 VCA-IgA 浓度在 NPC 诊断中的准确性数据。使用受试者工作特征曲线总结总体测试性能。
有 20 项研究符合荟萃分析的纳入标准。VCA-IgA 诊断 NPC 的汇总估计值为：敏感性 0.91（95%置信区间（CI）：0.90 - 0.92），特异性 0.92（95%CI：0.92 - 0.93），阳性似然比 31.65（95%CI：10.99 - 91.15），阴性似然比 0.10（95%CI：0.07 - 0.13）和诊断比值比 414.59（95%CI：174.96 - 982.42）。汇总受试者工作特征曲线下的面积为 0.98。
血清 VCA-IgA 的敏感性和特异性非常高，这表明外周血中 VCA-IgA 的存在是 NPC 的有价值的预测指标。
