摘要
目的：探讨ＥＢ病毒早期抗原（ＥＡ）ＩｇＧ抗体测定在鼻咽癌诊断和筛查中的应用。方法：对４５４例鼻咽癌和３００例健康人的血清分别用免疫酶法测定抗ＥＡ抗原的ＩｇＡ／ＥＡ抗体，用ＥＬＩＳＡ法测定ＩｇＧ／ＥＡ抗体，以及用抗酶率法测定抗ＥＢＶＤＮＡ酶抗体。并用免疫酶法测定ＩｇＡ／ＶＣＡ和ＥＬＩＳＡ法测定ＩｇＧ／ＥＡ的方法对鼻咽癌高发区人群的９５３６例血清进行鼻咽癌筛查。结果：３种方法中ＥＬＩＳＡ法检测ＩｇＧ／ＥＡ诊断鼻咽癌的效率最高（９２５％）。以双项检测阳性（ＩｇＧ／ＥＡＡ值≥０１８和ＩｇＡ／ＶＣＡ滴度≥１∶８０）为标准，鼻咽癌筛查的阳性预示值（鼻咽癌数／阳性血清数）为１６５％（１３／７９），高于单项阳性标准，Ｐ＜００５。结论：ＥＬＩＳＡ检测血清ＩｇＧ／ＥＡ的方法适用于鼻咽癌的血清学诊断，与检测ＩｇＡ／ＶＣＡ的免疫酶法联合应用的双阳性标准适合于在鼻咽癌筛查中采用。为了提高筛查的敏感性，建议将双项阳性标准中的ＩｇＡ／ＶＣＡ滴度定为≥１∶５。ＩｇＡ／ＶＣＡ滴度从≥１∶８升高到≥１∶５。
Objective: To study the application of the detection for IgG antibody to EBV EA in diagnosis and screening programs for NPC. Methods: The diagnostic efficiency for NPC in 3 methods (immuno enzyme method for IgA/EA antibody, ELISA for IgG/EA antibody and assay of anti enzyme rate for antibody to EBV DNAase) was evaluated with the serum panel from NPC (454 cases) and healthy individuals (300 cases). The sera of 9 536 cases from NPC high risk population were screened for NPC by immuno enzyme method for IgA/VCA and ELISA for IgG/EA. Result: The ELISA for IgG/EA had the highest diagnostic efficiency to NPC (92 5%) in the 3 methods ( P <0 001). With dual postiveness of IgG/EA A ≥0 18 and IgA/VCA titer≥1∶80 as cut off value of positive sera, the positive predictive value of diagnosis to NPC (number of NPC/number of positive sera) was 16 5%(13/79),the highest one ( P <0 001) in the 3 screening programs. Conclusion: The detection of IgG/EA by ELISA was adaptable to the serological diagnosis of NPC. In screening programs for NPC, the ELISA for IgG/EA would be suited to combine with immuno enzyme method for IgA/VCA, it might be better to take dual positiveness of IgG/EA A ≥0 18 and IgA/VCA titer≥1∶5 than that of IgG/EA A≥0 18 and IgA/VCA titer≥1∶80 in order to elevated serologic sensitivity to the screening programs for NPC.
出处
《中山医科大学学报》
CSCD
1999年第2期115-117,共3页
Academic Journal of Sun Yat-sen University of Medical Sciences
基金
广东省卫生厅科研基金
关键词
鼻咽癌
诊断
筛查
EBV-EA
IGG抗体
测定
nasopharyngeal neoplasms/diagnosis
multiphasic screening/methods
herpesvirus 4, human/immunology
antibodies, viral/analysis
