【摘要】：目的EB病毒感染與鼻咽癌發(fā)生、發(fā)展關(guān)系密切,EB病毒感染可導(dǎo)致嗜鉻蛋白A表達(dá)水平的改變。本課題將探討EB病毒DNA(EBV-DNA)、血清唾液酸(SA)、嗜鉻蛋白A(CgA)和EB病毒相關(guān)抗體,即EB病毒早期抗原免疫球蛋白A(EBV-EA-IgA)、EB病毒殼抗原免疫球蛋白A(EBV-CA-IgA)、EB病毒裂解期立即早期基因BRLF1的表達(dá)產(chǎn)物Rta蛋白抗體IgG (Rta-IgG)對(duì)鼻咽癌診斷的臨床評(píng)價(jià)。方法通過(guò)設(shè)計(jì)病例對(duì)照的方法,對(duì)鼻咽癌患者249例血清標(biāo)本進(jìn)行EBV-EA-IgA、EBV-CA-IgA、Rta-IgG、EBV-DNA、SA、CgA檢測(cè)并與健康體檢者50例、良性鼻炎患者50例和EBV-CA-IgA陽(yáng)性的健康體檢者50例作相關(guān)性分析。結(jié)果鼻咽癌患者血清中六項(xiàng)指標(biāo)水平明顯高于對(duì)照組,以單一指標(biāo)陽(yáng)性作為診斷標(biāo)準(zhǔn),EBV-EA-IgA、EBV-CA-IgA、Rta-IgG、EBV-DNA、SA、CgA對(duì)鼻咽癌患者的敏感度分別為31.37%、76.47%、67.65%、64.71%、58.82%、74.51%,特異度分別為96.0%、94.0%、98.0%、98.0%、84.0%、54.0%。同時(shí)聯(lián)合檢測(cè)兩項(xiàng)或兩項(xiàng)以上指標(biāo),結(jié)果顯示鼻咽癌患者診斷靈敏度可高達(dá)96.08%,特異度為95%。鼻咽癌患者經(jīng)過(guò)治療后血清Rta-IgG和EBV-DNA水平顯著降低。結(jié)論檢測(cè)血清EBV-EA-IgA、EBV-CA-IgA、Rta-IgG、EBV-DNA、SA、CgA對(duì)鼻咽癌的輔助診斷有較高的臨床實(shí)用價(jià)值。鼻咽癌的實(shí)驗(yàn)室診斷有必要進(jìn)行聯(lián)合檢測(cè)。EBV-DNA這一指標(biāo)可及時(shí)反映出鼻咽癌發(fā)展的動(dòng)態(tài),用于鼻咽癌患者療效監(jiān)測(cè),優(yōu)于Rta-IgG、 EBV-CA-IgA、EBV-EA-IgA。
[Abstract]:Objective EBV infection is closely related to the occurrence and development of nasopharyngeal carcinoma (NPC). EB virus infection can lead to the change of chromophore A expression. The purpose of this study was to investigate the clinical evaluation of EB virus DNA (EBV-DNA), serum sialic acid (SA), chromaffin A (CgA) and EB virus related antibodies, that is, EB virus early antigen immunoglobulin A (EBV-EA-IgA), EB virus shell antigen immunoglobulin A) (Rta protein antibody IgG (Rta-IgG), the expression product of immediate early gene BRLF1 during the cracking period of EBV-CA-IgA), EB virus) in the diagnosis of nasopharyngeal carcinoma (NPC). Methods the serum samples of 249 patients with nasopharyngeal carcinoma (NPC) were detected by case-control method and analyzed with 50 healthy subjects, 50 patients with benign rhinitis and 50 patients with positive EBV-CA-IgA. Results the serum levels of six indexes in patients with nasopharyngeal carcinoma were significantly higher than those in the control group. The sensitivity of EBV-EA-IgA,EBV-CA-IgA,Rta-IgG,EBV-DNA,SA,CgA to nasopharyngeal carcinoma patients was 31.37%, 76.47%, 67.65%, 64.71%, 58.82%, 74.51%, 96.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0%, 98.0% and 98.0%, respectively. 84.0%, 54.0%. At the same time, two or more indexes were detected jointly. The results showed that the diagnostic sensitivity and specificity of nasopharyngeal carcinoma patients were 96.08% and 95% respectively. The levels of serum Rta-IgG and EBV-DNA in patients with nasopharyngeal carcinoma (NPC) were significantly decreased after treatment. Conclusion the detection of serum EBV-EA-IgA,EBV-CA-IgA,Rta-IgG,EBV-DNA,SA,CgA has high clinical practical value in the auxiliary diagnosis of nasopharyngeal carcinoma. It is necessary to carry out joint detection in laboratory diagnosis of nasopharyngeal carcinoma. EBV-DNA can reflect the development of nasopharyngeal carcinoma in time and can be used to monitor the curative effect of nasopharyngeal carcinoma patients, which is superior to Rta-IgG, EBV-CA-IgA,EBV-EA-IgA..
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R739.63

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