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目的 比较鼻咽癌患者与健康人群血清EB病毒抗体水平 ,评估患鼻咽癌的危险度。方法 收集珠江口地区 12 1例鼻咽癌患者和 332例健康人血清。采用酶联吸附试验 (ELISA)检测血清中EBNA 1 IgA、EBNA 1 IgG和zta IgG ,以免疫酶法或免疫荧光法检测VCA IgA。结果 EBNA 1 IgA、EBNA 1 IgG和zta IgG的敏感度分别为 85 %、83%和 79% ;三者组合的敏感度最高 ,为 92 %。EBNA 1 IgA、EBNA 1 IgG和zta IgG的特异度分别为 86 %、86 %和 80 % ;三者组合的特异度最高 ,为 93%。根据优势比水平 ,可将患鼻咽癌的危险度分为低危险、中危险和高危险 3个层次。 93%的健康人是低危险的 ,优势比为 0 .0～ 0 .3;0 .4 %的健康人是高危险的 ,优势比为 137.9。结论 ELISA在诊断鼻咽癌的结果判断上更具客观性 ,较传统免疫酶法好 ;EBNA 1 IgA、EBNA 1 IgG和zta IgG的联合应用可以评估人群患鼻咽癌的危险度。
Objective To compare the serum level of Epstein-Barr virus (EBV) antibody in patients with nasopharyngeal carcinoma and healthy people and evaluate the risk of nasopharyngeal carcinoma. Methods A total of 121 cases of nasopharyngeal carcinoma (NPC) and 332 healthy controls were collected from the Pearl River Estuary. Serum EBNA 1 IgA, EBNA 1 IgG and zta IgG were detected by enzyme linked immunosorbent assay (ELISA), VCA IgA was detected by immunoenzymatic method or immunofluorescence method. Results The sensitivity of EBNA 1 IgA, EBNA 1 IgG and zta IgG were 85%, 83% and 79%, respectively. The sensitivity of the combination of the three was 92%. The specificity of EBNA 1 IgA, EBNA 1 IgG and zta IgG were 86%, 86% and 80%, respectively. The specificity of the three combinations was 93%. According to the level of superiority, the risk of nasopharyngeal cancer can be divided into low-risk, medium-risk and high-risk three levels. 93% of healthy people are low-risk, the odds ratio is 0-0.0.3; 0.4% of healthy people are at high risk, and the odds ratio is 137.9%. Conclusion ELISA is more objective in diagnosing nasopharyngeal carcinoma than traditional immunoenzymatic method. The combined use of EBNA 1 IgA, EBNA 1 IgG and zta IgG can assess the risk of nasopharyngeal carcinoma in the population.