EBV抗体和EBV-DNA在鼻咽癌诊断及分期的研究

发布时间：2018-05-06 12:47

本文选题：鼻咽癌 + EBV抗体　；参考：《中国肿瘤临床》2016年15期

【摘要】：目的:评估EBNA1/Ig A、Zta/Ig A、VCA/Ig A和EBV-DNA对不同分期鼻咽癌的诊断效能,探讨各指标阳性率与鼻咽癌分期的关系。方法:收集2010年3月至2015年9月中山大学附属中山医院收治的初诊鼻咽癌患者152例,健康体检者675例。采用酶联免疫吸附法(ELISA)检测血清EBNA1/Ig A、Zta/Ig A和VCA/Ig A抗体ROD值,荧光定量PCR(fluorescence quantitative PCR,FQPCR)检测血浆EBV-DNA水平。比较单独和联合应用EBV标记物对各期鼻咽癌的诊断效能,同时分析各指标阳性率与鼻咽癌分期的关系。结果:鼻咽癌患者EBNA1/Ig A、Zta/Ig A、VCA/Ig A和EBV-DNA阳性率显著高于健康体检者(P0.01)。EBNA1/Ig A在早期鼻咽癌表达相对较高,灵敏度为77.8%,而EBV-DNA在晚期鼻咽癌的灵敏度最高为88.8%,两者特异度均在96%以上。联合检测中EBNA1/Ig A并联EBV-DNA检测的灵敏度为92.1%(早期为82.5%、晚期为98.9%),特异度为96.9%。EBV-DNA阳性率与鼻咽癌临床分期和N分期呈正相关,Zta/Ig A阳性率与N分期呈正相关(P0.01)。结论:在无症状人群中进行鼻咽癌筛查,单项指标首选EBNA1/Ig A。晚期患者的辅助诊断则推荐EBV-DNA。两者并联检测可进一步提高鼻咽癌诊断效能。EBV-DNA是鼻咽癌分期和病情监测的重要指标,Zta/Ig A可间接反映淋巴结转移情况,有望对患者病情评估起到参考作用。
[Abstract]:Objective: to evaluate the diagnostic efficacy of EBNA1/Ig Ata-Ig Agna and EBV-DNA in different stages of nasopharyngeal carcinoma (NPC), and to explore the relationship between the positive rate of each index and the staging of nasopharyngeal carcinoma (NPC). Methods: from March 2010 to September 2015, 152 patients with nasopharyngeal carcinoma were treated in Zhongshan Hospital affiliated to Sun Yat-sen University. Elisa was used to detect the ROD values of serum EBNA1/Ig A Zta / Ig A and VCA/Ig A antibodies, and fluorescence quantitative PCR(fluorescence quantitative PCR was used to detect the plasma EBV-DNA level. To compare the diagnostic efficacy of EBV markers alone and in combination with each stage of nasopharyngeal carcinoma, and to analyze the relationship between the positive rate of each index and the stage of nasopharyngeal carcinoma. Results: the positive rates of EBNA1/Ig A / ZTA / Ig A and EBV-DNA in patients with nasopharyngeal carcinoma were significantly higher than those in healthy controls (P 0.01N. EBNA1 / IgA), and the sensitivity of EBV-DNA was 77.8% in early nasopharyngeal carcinoma, while the sensitivity of EBV-DNA in advanced nasopharyngeal carcinoma was 88.8%, the specificity of both was above 96%. The sensitivity of EBNA1/Ig A parallel EBV-DNA was 92. 1% (82.5% in the early stage and 98.9% in the late stage). The positive rate of 96.9%.EBV-DNA was positively correlated with the clinical stage and N stage of nasopharyngeal carcinoma. There was a positive correlation between ZTA / IgA positive rate and N stage. Conclusion: nasopharyngeal carcinoma screening is performed in asymptomatic population. The single index is EBNA1/Ig A. EBV-DNA is recommended for advanced diagnosis. The parallel detection can further improve the diagnostic efficacy of nasopharyngeal carcinoma. EBV-DNA is an important indicator of NPC staging and disease monitoring. Zta / Ig A can indirectly reflect the status of lymph node metastasis, which is expected to play a reference role in the evaluation of the patient's condition.
【作者单位】：中山大学附属中山医院中山市肿瘤研究所;
【基金】：国家自然科学基金项目(编号:81572062)资助~~
【分类号】：R739.63

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