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目的 比较血浆 /血清中的EB病毒 (Epstein Barrvirus,EBV)DNA检出率在健康成人和鼻咽癌患者之间的差别 ,评价其在鼻咽癌诊断中的意义。方法 从 5 8例健康成人和 66例未经治疗的鼻咽癌患者获取血浆和血清标本 ,用巢式PCR法检测EB病毒W片段。用免疫酶标法检测IgA/VCA滴度。结果 鼻咽癌患者血浆 /血清EB病毒DNA检出率为 84 85 % ,明显高于健康人 (10 34% )。血浆 /血清EB病毒DNA检测方法的敏感度 (0 84 85 )高于IgA/VCA(1∶4 0 )检测 (0 80 30 ) ,特异度相同 (均为 0 8966)。血浆 /血清EB病毒DNA和IgA/VCA(1∶4 0 )双阳性的正确率 (0 8387)、阳性实验预测值 (0 9792 )和优势比 (141 0 )比单独血浆 /血清EB病毒DNA阳性 (分别为 0 5 2 4 2 ,0 7333和 1 142 3)或IgA/VCA阳性者 (分别为 0 4 839,0 5 385和 1 0 4 80 )高。结论 用巢式PCR方法检测血浆 /血清中EB病毒DNA是诊断鼻咽癌有价值的指标之一。
Objective To compare the difference of plasma/serum Epstein Barr virus (EBV) DNA detection rate among healthy adult and nasopharyngeal carcinoma patients and evaluate its significance in the diagnosis of nasopharyngeal carcinoma. Methods Plasma and serum samples were obtained from 58 healthy adults and 66 untreated nasopharyngeal carcinoma patients. The EB virus W fragment was detected by nested PCR. The IgA/VCA titers were detected by immunoenzymatic method. Results The detection rate of plasma/serum Epstein-Barr virus DNA in patients with nasopharyngeal carcinoma was 84.85 %, which was significantly higher than that of healthy people (10 34%). The sensitivity of plasma/serum Epstein-Barr virus DNA assay (0 84 85) was higher than that of IgA/VCA (1:40) (0 80 30), and the specificity was the same (all 0 8966). The correct rate of double positive for plasma/serum Epstein-Barr virus DNA and IgA/VCA (1:40) (0 8387), positive predictive value (0 9792), and odds ratio (141 0) were higher than those of plasma/serum Epstein-Barr virus DNA alone (0 5 2 4 2, 0 7333, and 1 142 3, respectively) or IgA/VCA positive (0 4 839, 0 5 385, and 1 0 4 80, respectively). Conclusion The detection of Epstein-Barr virus DNA in plasma/serum by nested PCR is one of the most valuable markers for the diagnosis of nasopharyngeal carcinoma.