EBV specific antibody-based and DNA-BASED assays in serologic diagnosis of nasopharyngeal carcinoma
EBV specific antibody-based and DNA-BASED assays in serologic diagnosis of nasopharyngeal carcinoma
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DOI：
10.1002/ijc.11130
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发表时间：
2003-07-10
影响因子：
6.4
通讯作者：
Ng, MH
中科院分区：
文献类型：
--
作者：
Chan, KH;Gu, YL;Ng, MH
我们评估了5种EBV特异性检测对疑似鼻咽癌血清学诊断的影响。检测方法为免疫荧光检测、VCA IgA和EA IgA检测、EBNA I IgA或zta IgG特异性酶联免疫吸附检测和EBV DNA检测。在香港一所公立医院连续就诊的218名有症状的鼻咽癌患者抽取血清样本，其中51人随后被诊断为鼻咽癌；4例ebv相关肺癌，血清学与NPC相似。剩下的患者中有23人患有其他癌症，140人患有其他疾病。因此，在这种临床环境下，血清诊断的目的是排除和预测鼻咽癌的诊断。然而，没有一种单独的检测方法能充分满足这两种要求。EBNA I IgA和zta IgG的结合是克服这一困难的最佳方法。结果显示，68.3%的患者在两项检测中均给出了确诊结果，无论是阴性还是阳性。确诊的阴性结果与99.1%的阴性预测值相关，为排除鼻咽癌的诊断提供了明确的指征；确诊的阳性结果与86.8%的阳性预测值相关，为继续进行鼻咽癌的诊断检查提供了明确的指示。其余患者的检测结果模棱两可，一项检测阳性或另一项检测阳性，阳性预测值分别为43.3%和24.2%。
We assessed 5 EBV specific assays for their capacity to effect serologic diagnosis of suspected NPC. The assays were the immunofluorescent assays, VCA IgA and EA IgA, the enzyme-linked immunosorbent assays specific for EBNA I IgA or zta IgG and an EBV DNA assay. Serum samples were taken from 218 symptomatic NPC patients presenting consecutively at a public hospital in Hong Kong, 51 of whom were subsequently diagnosed as having NPC; 4 had EBV-associated lung cancer with similar serology as NPC. The remaining patients included 23 who had other cancers and 140 who had other diseases. Objectives of serodiagnosis under such clinical settings, therefore, are to both exclude and predict a diagnosis of NPC. None of the assays individually can meet both requirements adequately, however. The difficulty was best overcome by combining EBNA I IgA and zta IgG. It was shown that 68.3% of the patients gave a confirmed test results, negative or positive, by both tests. A confirmed negative result was associated with a negative predictive value of 99.1%, providing a clear indication to exclude a diagnosis of NPC; a confirmed positive result was associated with a positive predictive value of 86.8%, providing a clear indication to proceed with diagnostic work-up of NPC. The remaining patients gave equivocal test results, being positive for one or the other test, which were associated with a positive predictive value of 43.3% and 24.2%, respectively.