鼻咽癌实验室诊断指标的相关性研究

发布时间：2019-06-26 19:41

【摘要】：目的EB病毒感染与鼻咽癌发生、发展关系密切,EB病毒感染可导致嗜铬蛋白A表达水平的改变。本课题将探讨EB病毒DNA(EBV-DNA)、血清唾液酸(SA)、嗜铬蛋白A(CgA)和EB病毒相关抗体,即EB病毒早期抗原免疫球蛋白A(EBV-EA-IgA)、EB病毒壳抗原免疫球蛋白A(EBV-CA-IgA)、EB病毒裂解期立即早期基因BRLF1的表达产物Rta蛋白抗体IgG (Rta-IgG)对鼻咽癌诊断的临床评价。方法通过设计病例对照的方法,对鼻咽癌患者249例血清标本进行EBV-EA-IgA、EBV-CA-IgA、Rta-IgG、EBV-DNA、SA、CgA检测并与健康体检者50例、良性鼻炎患者50例和EBV-CA-IgA阳性的健康体检者50例作相关性分析。结果鼻咽癌患者血清中六项指标水平明显高于对照组,以单一指标阳性作为诊断标准,EBV-EA-IgA、EBV-CA-IgA、Rta-IgG、EBV-DNA、SA、CgA对鼻咽癌患者的敏感度分别为31.37%、76.47%、67.65%、64.71%、58.82%、74.51%,特异度分别为96.0%、94.0%、98.0%、98.0%、84.0%、54.0%。同时联合检测两项或两项以上指标,结果显示鼻咽癌患者诊断灵敏度可高达96.08%,特异度为95%。鼻咽癌患者经过治疗后血清Rta-IgG和EBV-DNA水平显著降低。结论检测血清EBV-EA-IgA、EBV-CA-IgA、Rta-IgG、EBV-DNA、SA、CgA对鼻咽癌的辅助诊断有较高的临床实用价值。鼻咽癌的实验室诊断有必要进行联合检测。EBV-DNA这一指标可及时反映出鼻咽癌发展的动态,用于鼻咽癌患者疗效监测,优于Rta-IgG、 EBV-CA-IgA、EBV-EA-IgA。
[Abstract]:Objective EBV infection is closely related to the occurrence and development of nasopharyngeal carcinoma (NPC). EB virus infection can lead to the change of chromophore A expression. The purpose of this study was to investigate the clinical evaluation of EB virus DNA (EBV-DNA), serum sialic acid (SA), chromaffin A (CgA) and EB virus related antibodies, that is, EB virus early antigen immunoglobulin A (EBV-EA-IgA), EB virus shell antigen immunoglobulin A) (Rta protein antibody IgG (Rta-IgG), the expression product of immediate early gene BRLF1 during the cracking period of EBV-CA-IgA), EB virus) in the diagnosis of nasopharyngeal carcinoma (NPC). Methods the serum samples of 249 patients with nasopharyngeal carcinoma (NPC) were detected by case-control method and analyzed with 50 healthy subjects, 50 patients with benign rhinitis and 50 patients with positive EBV-CA-IgA. Results the serum levels of six indexes in patients with nasopharyngeal carcinoma were significantly higher than those in the control group. The sensitivity of EBV-EA-IgA,EBV-CA-IgA,Rta-IgG,EBV-DNA,SA,CgA to nasopharyngeal carcinoma patients was 31.37%, 76.47%, 67.65%, 64.71%, 58.82%, 74.51%, 96.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0% and 98.0%, respectively. 84.0%, 54.0%. At the same time, two or more indexes were detected jointly. The results showed that the diagnostic sensitivity and specificity of nasopharyngeal carcinoma patients were 96.08% and 95% respectively. The levels of serum Rta-IgG and EBV-DNA in patients with nasopharyngeal carcinoma (NPC) were significantly decreased after treatment. Conclusion the detection of serum EBV-EA-IgA,EBV-CA-IgA,Rta-IgG,EBV-DNA,SA,CgA has high clinical practical value in the auxiliary diagnosis of nasopharyngeal carcinoma. It is necessary to carry out joint detection in laboratory diagnosis of nasopharyngeal carcinoma. EBV-DNA can reflect the development of nasopharyngeal carcinoma in time and can be used to monitor the curative effect of nasopharyngeal carcinoma patients, which is superior to Rta-IgG, EBV-CA-IgA,EBV-EA-IgA..
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.63

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