摘要
目的:探讨和评价4种常用的EB病毒抗体及其二联组合检测在酶联免疫吸附法(ELISA)辅助诊断鼻咽癌中的价值,以期进一步提高鼻咽癌的血清学诊断水平,并探讨单独检测1种EB病毒抗体时以何者为优良,以及采用何种组合检测两种抗体更合适。方法:收集广州地区195例病理学证实的新诊鼻咽癌患者和188例健康成人血清。应用EB病毒特异抗原(谷胱甘肽转移酶重组蛋白)为基础的4种ELISA,即EBNA1-IgA、EBNA1-IgG、Zta-IgA和Zta-IgG,检测血清中抗EB病毒的抗体水平。结果:单独应用1种ELISA、EBNA1-IgA的灵敏度(0.8513)和特异度(0.8511)最高。Zta-IgG和Zta-IgA的灵敏度和特异度分别为0.8359和0.8351以及0.8103和0.8185。EBNA1-IgG的灵敏度和特异度最低,分别为0.6974和0.6968。无论哪两种ELISA的组合,其特异度和阳性预测价值可分别达到0.9255和0.9032以上。EBNA1-IgA和Zta-IgA组合的优势比和阳性似然比(分别为50.6263和14.9875)最高;EBNA1-IgA和Zta-IgG组合的优势比和阳性似然比(分别为37.0909和11.9214)次之。结论:在单独应用ELISA法血清学诊断鼻咽癌的4种EB病毒抗体中,以EBNA1-IgA为最佳,其次是Zta-IgG。2种ELISA组合应用将明显地提高血清学诊断鼻咽癌的价值。在临床实践中以EBNA1-IgA与Zta-IgA或Zta-IgG的组合为宜。
Objective Detection of serum levels of the antibodies against EBV by enzyme-linked immunosorbent assay （ELISA） has newly developed for the serological diagnosis of nasopharyngeal carcinoma （NPC）. This study is to investigate 4 common antibodies against EBV and the values of dual combination of ELISA in the diagnosis of NPC and to expect to further improve the serological diagnosis of NPC. Methods Serum samples were collected from 195 patients with pathologically diagnosed NPC and from 188 healthy adults in Guangzhou area. Levels of anti-EBV antibodies in the sera were detected by 4 ELISAs based on EBV specific recombinant antigens （glutathione transferase fusion proteins）, namely, EBNA1-IgA, EBNA1-IgG, Zta-IgA, and Zta-IgG. Results Among the 4 ELISAs used separately, the sensitivity and specificity of EBNA1-IgA were the highest （0.851 3 and 0.851 1, respectively）. The sensitivity and specificity of Zta-IgG were 0.835 9 and 0.835 1, respectively; those of Zta-IgA were 0.810 3 and 0.818 5. The sensitivity and specificity of EBNA1-IgG were the lowest （0.697 4 and 0.696 8, respectively）. The specificity and positive predictive value of any dual combination of ELISA could reach more than 0.925 5 and 0.903 2. The odds ratio and positive likelihood ratio of EBNA1-IgA combined with Zta-IgA were the highest （50.626 3 and 14.987 5, respectively）, followed by those of EBNAI-IgA plus Zta-IgG （37.090 9 and 11.921 4, respectively）. Conclusions Among the 4 types of ELISAs used separately for the serological diagnosis of NPC, EBNA1-IgA is the best, followed by Zta-IgG. Dual combination of ELISA markedly enhances the values of serological diagnosis of NPC. Our study reveals that EBNA1-IgA combined with either Zta-IgA or Zta-IgG is recommendable in the clinical practice.
出处
《实用医学杂志》
CAS
2008年第17期3055-3058,共4页
The Journal of Practical Medicine
关键词
鼻咽肿瘤
疱疹病毒4型
人
酶联免疫吸附测定
Nasopharyngeal neoplasms Herpesvirus 4, human Enzyme-linked immunosorbent assay
