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流行病学、血清学和分子生物学的资料证实,爱泼斯坦-巴尔病毒(EBV感染与鼻咽癌(NPC)有密切关系。血清EBV-VCA-IgA,EBV-EA-IgA测定和聚合酶链(PCR)检测组织中EBV-DNA已用于NPC的临床诊断。本文评价上述方法在NPC诊断中的实用价值。85例病人双盲法测定血清EBV-VCA-IgA(I),EBV-EA-IgA(Ⅱ):鼻咽活检组织用PCR法检测EBV-DNA(Ⅲ)和组织病理检测(Ⅳ)。组织病理学证实:NPC57例;非NPC28例作为对照组。57例NPC中,(Ⅰ)、(Ⅱ)、(Ⅲ)的阳性率分别为66.7%,21.1%,80.7%;(Ⅰ)+(Ⅱ),(Ⅰ)+(Ⅲ),(Ⅱ)+(Ⅲ)或(Ⅰ)+(Ⅱ)+(Ⅲ)的阳性率分别为21.1%,56.1%,19.3%,19.3%(P<0.005)。28例对照组(Ⅰ)、(Ⅱ)或(Ⅲ)的阴性率分别为75%,100%,100%;(Ⅰ)+(Ⅱ),(Ⅰ)+(Ⅲ),或(Ⅰ)+(Ⅱ)+(Ⅲ)均为对.4%(P<0.005)。本组结果提示,PCR法检测EBV-DNA具有灵敏度高(NPC的阳性率高)和特异性强(对照组的阴性率高)的特点。
Epidemiological, serological and molecular biological data confirm Epstein-Barr virus (EBV infection is closely related to NPC.) Serum EBV-VCA-IgA, EBV-EA-IgA assay and polymerase (EBV-DNA) has been used in the clinical diagnosis of NPC.This article evaluates the practical value of the above method in the diagnosis of NPC.Methods: Eighty-five patients were tested for the serum levels of EBV-VCA-IgA (I), EBV-EA IgA (Ⅱ): EBV-DNA was detected by PCR in nasopharyngeal biopsies (Ⅲ) and histopathological examination (Ⅳ) .Histopathology confirmed that 57 NPC were NPC patients, ), (Ⅱ) and (Ⅲ) were 66.7%, 21.1% and 80.7% respectively; (Ⅰ) + Ⅲ) or (Ⅰ) + (Ⅱ) + (Ⅲ) were 21.1%, 56.1%, 1 .3% and 19.3%, respectively (P <0.005) .The negative rates of (Ⅰ), (Ⅱ) and (Ⅲ) in the 28 cases were 75%, 100% and 100% (P <0.005) .This group of results suggest that PCR detection of EBV-DNA has the sensitivity High (high positive rate of NPC) and strong specificity (negative rate of the control group).