[不同临床分期下爱泼斯坦-巴尔病毒Rta-IgG、VCA-IgA、EA-IgA及爱泼斯坦-巴尔病毒DNA检测法在鼻咽癌诊断中的评估]

[Assessment of detection assays of Epstein-Barr viral Rta-IgG, VCA-IgA, EA-IgA and Epstein-Barr viral DNA at different clinical stages in the diagnosis of nasopharyngeal carcinoma].

作者信息

Luo Yao-ling, Chen Hao, Peng Song-guo, Lin Jian-hua, Huang Pei-yu

机构信息

State Key Laboratory of Oncology in South China, Department of Clinical Laboratory Medicine, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine,Guangzhou 510060, China.

State Key Laboratory of Oncology in South China, Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine,Guangzhou 510060, China. Email: huangpy @sysucc.org.cn.

出版信息

Zhonghua Yi Xue Za Zhi. 2013 Nov 26;93(44):3516-9.

PMID:24521892

Abstract

OBJECTIVE

To evaluate the values of combined detection method of EB viral Rta-IgG, VCA-IgA, EA-IgA and EB viral DNA in the diagnosis of nasopharyngeal carcinoma (NPC).

METHODS

Serum and plasma samples from 131 untreated NPC patients, 52 non-NPC patients with NPC-like symptoms and 148 healthy donors from January to December 2012 were collected. Immunoenzymatic staining was used to detect VCA-IgA and EA-IgA in sera. ELISA was performed to detect Rta-IgG antibody in sera and real-time fluorescent quantitative PCR for measuring EBV DNA in plasma. The clinical characteristics of 3 groups were compared. ROC curve and correlation analyses were performed to assess the detection assays for the diagnosis of NPC.

RESULTS

The positive rates of EBV Rta-IgG, VCA-IgA, EA-IgA and EBV DNA in untreated NPC patient group were higher than those in other two groups. The differences were statistically significant (all P < 0.01). The differences of Rta-IgG antibody positive rates, EBV-DNA levels and EBV-DNA positive rates at different clinical stages were statistically significant (all P < 0.05). The positive rates of VCA-IgA and EA-IgA were not related with clinical stages (P > 0.05). Areas under ROC curve for Rta-IgG and EBV-DNA were 0.901 and 0.827 respectively. All four diagnostic assays demonstrated excellent efficiency. The sensitivity and specificity of individual assays were as follows: Rta-IgG: 77.9%, 92.5%; VCA-IgA 93.1%, 91.5%; EA-IgA: 74.8%, 99.5%; EBV-DNA 64.9%, 97.0%. The sensitivity and specificity of combined assays were 97.7% and 83.5% respectively.

CONCLUSION

Combined detection method of EB viral Rta-IgG, VCA-IgA, EA-IgA and EB viral DNA are efficient for the diagnosis of NPC.

摘要

目的

评估EB病毒Rta-IgG、VCA-IgA、EA-IgA及EB病毒DNA联合检测方法在鼻咽癌（NPC）诊断中的价值。

方法

收集2012年1月至12月期间131例未经治疗的NPC患者、52例有NPC样症状的非NPC患者及148例健康供者的血清和血浆样本。采用免疫酶染色法检测血清中的VCA-IgA和EA-IgA。采用酶联免疫吸附测定法检测血清中的Rta-IgG抗体，采用实时荧光定量聚合酶链反应法检测血浆中的EBV DNA。比较3组的临床特征。绘制ROC曲线并进行相关性分析，以评估各检测方法对NPC的诊断价值。

结果

未经治疗的NPC患者组中EBV Rta-IgG、VCA-IgA、EA-IgA及EBV DNA的阳性率高于其他两组。差异具有统计学意义（均P < 0.01）。不同临床分期的Rta-IgG抗体阳性率、EBV-DNA水平及EBV-DNA阳性率差异具有统计学意义（均P < 0.05）。VCA-IgA和EA-IgA的阳性率与临床分期无关（P > 0.05）。Rta-IgG和EBV-DNA的ROC曲线下面积分别为0.901和0.827。所有四种诊断检测方法均显示出良好的效能。各单项检测方法的灵敏度和特异度如下：Rta-IgG：77.9%，92.5%；VCA-IgA 93.1%，91.5%；EA-IgA：74.8%，99.5%；EBV-DNA 64.9%，97.0%。联合检测方法的灵敏度和特异度分别为97.7%和83.5%。