Ringborg U, Henle W, Henle G, Ingimarsson S, Klein G, Silfversward C, Strander H
Cancer. 1983 Oct 1;52(7):1237-43. doi: 10.1002/1097-0142(19831001)52:7<1237::aid-cncr2820520718>3.0.co;2-p.
Sera from 256 patients with cancers of the head and neck were examined for their profiles of IgG and IgA antibodies to Epstein-Barr virus (EBV)-specific, viral capsid antigen (VCA), the diffuse (D) and the restricted (R) components of the early antigen (EA) complex, and the EBV-associated nuclear antigen (EBNA), in order to assess the value of these procedures in the routine diagnosis of poorly or undifferentiated nasopharyngeal carcinoma (NPC). In 13 NPC patients, the carcinoma had invaded cervical lymph nodes, and their sera revealed, in addition to high IgG anti-VCA titers, elevated levels of IgA antibodies to VCA, of IgG antibodies to D, and most also had IgA anti-D. Such profiles were seen in very few of the patients with carcinomas at other sites of the head and neck. They had not developed in four NPC patients whose tumors were limited to the postnasal space, and in three patients with other tumors at that site. Among 15 patients with cervical node metastases from occult primary tumors, 2 had EBV-specific antibody profiles compatible with NPC, 1 was judged to have NPC on clinical grounds, and the other died of a pulmonary carcinoma, or possibly pulmonary metastases. In 4 of the remaining 13 patients with occult tumors, the primary site was found outside the nasopharynx, whereas it escaped detection in the other 9. These results lend further support to the usefulness of the EBV-specific serology to clinicians in the diagnosis of NPC, especially in cases of lymph node invasion by undetected primary tumors. The data also emphasize the need of complementing the serology with the examination of biopsies for the presence of EBV deoxyribonucleic acid (DNA) or, more readily performed, EBNA-positive carcinoma cells.
检测了256例头颈部癌症患者血清中针对爱泼斯坦-巴尔病毒（EBV）特异性病毒衣壳抗原（VCA）、早期抗原（EA）复合物的弥散（D）成分和受限（R）成分以及EBV相关核抗原（EBNA）的IgG和IgA抗体谱，以评估这些检测方法在低分化或未分化鼻咽癌（NPC）常规诊断中的价值。13例NPC患者的癌已侵犯颈部淋巴结，其血清除了IgG抗VCA滴度高外，还显示VCA的IgA抗体水平升高、D的IgG抗体水平升高，且大多数还具有IgA抗D。在头颈部其他部位患有癌症的患者中，很少见到这样的抗体谱。在4例肿瘤局限于后鼻孔间隙的NPC患者以及3例该部位患有其他肿瘤的患者中未出现这样的抗体谱。在15例隐匿性原发肿瘤颈部淋巴结转移患者中，2例具有与NPC相符的EBV特异性抗体谱，1例根据临床判断为NPC，另1例死于肺癌或可能是肺转移。在其余13例隐匿性肿瘤患者中，4例的原发部位在鼻咽部以外，而另外9例未检测到。这些结果进一步支持了EBV特异性血清学对临床医生诊断NPC的有用性，尤其是在未检测到的原发肿瘤侵犯淋巴结的病例中。数据还强调需要通过检查活检组织中EBV脱氧核糖核酸（DNA）的存在情况或更容易进行的EBNA阳性癌细胞检测来补充血清学检测。
