Complementary serum test of antibodies to Epstein-Barr virus nuclear antigen-1 and early antigen: A possible alternative for primary screening of nasopharyngeal carcinoma
Complementary serum test of antibodies to Epstein-Barr virus nuclear antigen-1 and early antigen: A possible alternative for primary screening of nasopharyngeal carcinoma
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DOI：
10.1016/j.oraloncology.2007.10.003
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发表时间：
2008-08-01
期刊：
影响因子：
4.8
通讯作者：
Hao, Sheng-Po
中科院分区：
文献类型：
--
作者：
Chang, Kai-Ping;Hsu, Cheng-Lung;Hao, Sheng-Po
本以医院为基础的队列研究评估了三种eb病毒（EBV）相关检测在鼻咽癌（NPC）初步筛查和监测治疗结果中的疗效。共纳入517例连续受试者，包括156例鼻咽癌患者、264例健康志愿者和97例头颈部鳞状细胞癌患者。采用免疫荧光法、酶联免疫吸附法检测EBV IgAs对病毒衣壳抗原（VCA）、早期抗原和核抗原-1 （EA + EBNA-1）、EBV DNA蟾蜍的敏感性和特异性。和实时荧光定量PCR。通过构建接受者工作特征来证明筛查效果，EBV EA + EBNA-1 IgA （AUC: 0.952; 95% CI, 0.930-0.974）在鉴别鼻咽癌患者与对照组方面优于EBV VCA IgA （AUC: 0.888; 95% CI, 0.854-0.922）或EBV DNA载量（AUC: 0.893; 95% CI, 0.854-0.932）。鼻咽癌患者与HNSCC患者筛查效果比较显示，EBV EA + EBNA-1 IgA （AUC: 0.964; 95% CI: 0.943 ~ 0.985）仍优于EBV VCA IgA （AUC: 0.884; 95% CI: 0.845 ~ 0.923）。在EBV VCA IgA和EA + EBNA-1 IgA血清滴度较高或浓度≥1:80、≥6 EU/ml的受试者中，对照组特异性分别高达99.2%和95.1%。然而，这三项检测与鼻咽癌临床病理表现的相关性显示，只有EBV DNA与鼻咽癌N期和总分期有显著相关性。此外，EBV DNA蟾蜍可用于进一步提高EBV EA + EBNA-1 IgA检测的特异性，并且根据时间框架的系列检测结果，也是唯一能够一致预测治疗后患者肿瘤复发的检测方法。因此，建议采用EBV EA + EBNA-1 iga的方案进行大规模筛查，但EBV DNA载量应仅用于流行地区鼻咽癌治疗后监测。(c) 2007 Elsevier Ltd.版权所有。
This hospital-based cohort study evaluated the efficacy of three Epstein-Barr virus (EBV) - associated assays for nasopharyngeal carcinoma (NPC) primary screening and monitoring treatment outcome. Five hundred and seventeen consecutive subjects, including 156 NPC patients, 264 healthy volunteers and 97 patients with head and neck squamous cell carcinoma (HNSCC) were enrolled. The sensitivity and specificity of EBV IgAs to viral capsid antigen (VCA), complementary EBV IgAs to early antigen and nuclear antigen-1 (EA + EBNA-1), and EBV DNA toad were examined by immunofluorescent assays, enzyme-linked immunosorbent. assays, and quantitative real-time PCR, respectively. After constructing the receiver operating characteristics to demonstrate screening efficacy, EBV EA + EBNA-1 IgA (AUC: 0.952; 95% CI, 0.930-0.974) was proved superior to EBV VCA IgA (AUC: 0.888; 95% CI, 0.854-0.922) or EBV DNA load (AUC: 0.893; 95% CI, 0.854-0.932) in differentiating NPC patients from controls. Comparison of screening efficacy between NPC patients and HNSCC patients revealed EBV EA + EBNA-1 IgA (AUC: 0.964; 95% CI, 0.943-0.985) still outperformed EBV VCA IgA (AUC: 0.884; 95% CI, 0.845-0.923). In subjects with higher serum titer or level equal to or above 1:80 and 6 EU/ml for EBV VCA IgA and EA + EBNA-1 IgA, the specificity reached as high as 99.2% and 95.1%, respectively, in the control groups. However, correlation of these three assays with clinicopathological manifestations of NPC, revealed only EBV DNA toad significantly associated with N stage and overall stage in NPC patients. Additionally, EBV DNA toad could be used to further raise the specificity of EBV EA + EBNA-1 IgA assays and was also the only assay to be consistently predictive of tumor relapse in post-treatment patients according to serial test results by time frame. Consequently, an EBV EA + EBNA-1 IgA-based protocol is recommended for mass screening, but EBV DNA load should be used solely for post-treatment monitoring for NPC in endemic areas. (c) 2007 Elsevier Ltd. All rights reserved.