[The combined interpretation schemes including VCA-IgA, EA-IgA and Rta-IgG in the diagnosis of nasopharyngeal carcinoma]

X H Yi; H C Lai; J Z Liu; S C Lin; C Li; X Q Chen; D S Wang

doi:10.13201/j.issn.1001-1781.2018.22.014

[The combined interpretation schemes including VCA-IgA, EA-IgA and Rta-IgG in the diagnosis of nasopharyngeal carcinoma]

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Nov;32(22):1740-1744. doi: 10.13201/j.issn.1001-1781.2018.22.014.

[Article in Chinese]

Authors

X H Yi¹, H C Lai¹, J Z Liu¹, S C Lin¹, C Li¹, X Q Chen¹, D S Wang¹

Affiliation

¹ Department of Otolaryngology Head and Neck Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, China.

PMID: 30716808
DOI: 10.13201/j.issn.1001-1781.2018.22.014

Abstract
in English, Chinese

Objective:To compare the performances of VCA-IgA, EA-IgA and Rta-IgG in the diagnosis of nasopharyngeal carcinoma, and find the most appropriate combined interpretation scheme. Method:The current study included a total of 346 subjects. Ninety-six subjects were nasopharyngeal carcinoma cases which were pathologically verified by the biopsy under electronic laryngoscope. The remaining 250 subjects, who received EBV tests at the same period, were normal healthy individuals without nasopharyngeal carcinoma. VCA-IgA, EA-IgA and Rta-IgG were detected in all cases. The clinial data were analyzed retrospectively. Result:Best cutoff points of VCA-IgA, EA-IgA and Rta-IgG in the diagnosis of nasopharyngeal carcinoma were 1.37 s/co, 0.706 s/co and 0.817 s/co; the sensitivities were 88.5%,49.0% and 65.6%; the specificities were 88.8%,96.0% and 95.2%, respectively. The diagnostic accuracy of VCA-IgA was significantly higher than that of EA-IgA and Rta-IgG (P<0.05). Three combined interpretation schemes were developed based on the VCA-IgA: ①VCA-IgA+EA-IgA; ②VCA-IgA+Rta-IgG; ③VCA-IgA+EA-IgA+Rta-IgG. Compared to the VCA-IgA, all the combined interpretation schemes had increased sensitivities and decreased specificities. The scheme 3 had the highest sensitivity. And the scheme 2 had the highest Youden index, and a comparable diagnosis accuracy to that of VCA-IgA (P>0.05). Conclusion:VCA-IgA, EA-IgA and Rta-IgG were all helpful indicators in the diagnosis of nasopharyngeal carcinoma. VCA-IgA was more accurate than the EA-IgA and Rta-IgG. Combined interpretation schemes were helpful in improving the sensitivity. Because the clinical symptoms of nasopharyngeal carcinoma are often insidious and the missed diagnosis by serological examination may lead to serious consequences. It is of clinical value to adopt the combined interpretation schemes to improve the diagnostic sensitivity of nasopharyngeal carcinoma.

目的：分析EB病毒（EBV）衣壳抗原（VCA）-IgA、早期抗原（EA）-IgA和Rta-IgG用于诊断鼻咽癌的最佳诊断水平，对比三者的诊断准确性，并探讨最合适的联合解读方案。方法：本研究共纳入研究对象346例，其中病例组96例，均为电子鼻咽镜下活检病理确诊的鼻咽癌患者；对照组250例，均为同期门诊体检行EBV血清学检测并经电子鼻咽镜排除鼻咽癌的健康者。所有研究对象均行VCA-IgA、EA-IgA、Rta-IgG检测。结果：以VCA-IgA、EA-IgA和Rta-IgG分别进行诊断，三者的最佳诊断水平分别是1.37 s/co、0.706 s/co和0.817 s/co；灵敏度分别为88.5%、49.0%和65.6%；特异度分别为88.8%、96.0%和95.2%。VCA-IgA的诊断准确性均显著高于EA-IgA和Rta-IgG（P<0.05）。在VCA-IgA的基础上，加入VCA-IgA和Rta-IgG组成3种联合解读方案：VCA-IgA+EA-IgA、VCA-IgA+Rta-IgG和VCA-IgA+EA-IgA+Rta-IgG。较单独使用VCA-IgA，此3种联合解读方案在灵敏度上均有所提高，特异度均下降，其中以VCA-IgA+EA-IgA+Rta-IgG的灵敏度最高；以VCA-IgA+Rta-IgG的Youden指数最大，且诊断准确性不显著低于VCA-IgA（P＞0.05）。结论：VCA-IgA、EA-IgA和Rta-IgG均为临床可用的鼻咽癌诊断指标，VCA-IgA的诊断准确性优于EA-IgA和Rta-IgG。联合解读方案有助于提高鼻咽癌诊断的灵敏度，由于鼻咽癌临床症状往往不明显，血清学检查如果漏诊可能会引起严重后果，采取联合解读方案对提高鼻咽癌筛查灵敏度具有一定的临床价值。.

Keywords: EA-IgA; EBV; Rta-IgG; VCA-IgA; nasopharyngeal neoplasms.

Publication types

English Abstract

Abstract in English, Chinese

Publication types

Abstract
in English, Chinese