Serological Antibodies And EBV-DNA Analysis Of Patients With Nasopharyngeal Carcinoma And EB Virus Infection

Object:(1)By analyzing the levels of serum antibodies and EBV-DNA in nasopharyngeal carcinoma and EBV-infected patients and the pattern of antibody positive detection,it is explored whether EB virus serum antibody and EBV-DNA test can improve the diagnosis of nasopharyngeal carcinoma and as a super early warning of screening for high-risk groups of nasopharyngeal cancer.(2)Analysis of serological antibodies in different clinical stages in nasopharyngeal carcinoma to understand whether serum antibody levels in nasopharyngeal carcinoma’s different clinical stages has related with pathological stage.Then discussion the serum levels of VCA-IgA,EA-IgA,and Rta-IgG in nasopharyngeal carcinoma patients’ different ages.Methods:Collected from September 2016 to September 2017 at the First Affiliated Hospital of Hainan Medical College,the Second Affiliated Hospital of Hainan Medical College,Haikou Maternal and Child Health Hospital,and Haikou People’s Hospital’s Department of Otolaryngology and Oncology of the 182 patients diagnosed with nasopharyngeal carcinoma,235 patients non-nasopharyngeal carcinoma were diagnosed by EB virus confirmed in outpatient service,and 139 healthy patients.Serum levels of VCA-IgA,EA-IgA,and Rta-IgG were tested by Enzyme-Linked Immunosorbent Assay(ELISA).EBV-DNA was tested by fluorescent quantitative PCR.Then analyzed for patients of NPC and EBV infection’s Serum antibody levels and EBV-DNA positive rate,and tested antibody positive patterns.Compared with the sensitivity,specificity and Youden index of each indexs,The Receiver operating chamteristic curve(ROC curve)was plotted,it was evaluated and compared the diagnostic efficacy of the four test indexes.Results:(1)The positive rate of VCA-IgA was the highest in 182 patients in nasopharyngeal carcinoma,is(93.9%,171/182),then Rta-IgG is(89.5%,136/182),The EBV-DNA positive rate was the lowest,is15.3%(28/182);The positive rate of antibodies pattern in the nasopharyngeal carcinoma was the highest with VCA-IgA+Rta-IgG,which was 70.88%(129/182),then VCA-IgA+EA-IgA,is 51.10%(93/182),there was only one patient was negative for three antibodies.(2)The positive rate of Rta-IgG was the highest in 235 cases of EB virus infection,which was 69.3%(163/235),then VCA-IgA,is 68.9%(162/235),and the lowest rate of EBV-DNA positive was 3.8%;The highest positive rate of antibodies pattern was EA-IgA+Rta-IgG in the EB virus infection group,which was 39.15%(92/235),and VCA-IgA+Rta-IgG 25.96%(61 /235).The positive rates of VCA-IgA,EA-IgA,and Rta-IgG in 139 healthy subjects were 4.3%(6/139),1.4%(2/139),and 4.3%(6/139).Besides,there was only one positive pattern antibody in this group was EA-IgA+Rta-IgG.(3)The positive rates of each antibody in the nasopharyngeal carcinoma group,the EB virus infection group and the healthy control group all had statistically significant(P<0.05).The comparison of antibodies between the groups showed that only Rta-IgG has no significant difference between the pharyngeal carcinoma group and the EB virus infection group(P>0.05).The positive levels of the three antibodies increased with age from 21~40 to 41~60,but decreased from 41~60 to ≥61,but the differences hadn’t statistically significant(P>0.05).In comparison of serological antibody levels in different clinical stages of NPC,VCA-IgA positive rates has statistically different between stage I and stage III,stage I and stage IV,stage III and stage III,stage IV and stage IV(P<0.05);Rta-IgG positive rate was statistically significant only in the period between phase I and III(P<0.05).(4)In the correlation analysis,there was a significant positive correlation between VCA-IgA and EA-IgA and Rta-IgG(r=0.407,0.238,P<0.05),and there was a significant positive correlation between Rta-IgG and EA-IgA(r= 0.285,P< 0.05).Compared with the sensitivity,specificity,Youden index,and area under the ROC curve of the three serum antibodies and EBV-DNA,the highest Sensitivity was VCA-IgA(93.3%).The specificities of EA-IgA and EBV-DNA were the highest,were 98.5% and 100%.The Yorden index(0.889 and 0.851)and the area under the curve(0.986 and 0.907)of VCA-IgA and Rta-IgG were the best,the sensitivity of the three antibodies tandem was 51.10%(93/181),the specificity was 100%(182/182);the sensitivity and specificity of the parallel They were 99.45%(181/182)and 86.33%(124/139).Conclusions:(1)There’s highly detected rate in the nasopharyngeal carcinoma group with serum antibodies VCA-IgA,EA-IgA,and Rta-IgG,the prominent antibody positive situation in EB virus infection group was similar to nasopharyngeal carcinoma group.EBV-The detection rate of DNA in nasopharyngeal carcinoma and EB virus infection groups was relatively low.Serological antibody test can be used as a common method for clinical diagnosis and high-risk screening of nasopharyngeal carcinoma.(2)The antibody levels in the advanced age nasopharyngeal carcinoma group were higher than the younger age group,and difference antibody levels were no statistically significant in different age groups,the positive rate of each antibody in nasopharyngeal carcinoma patients increased with the increase of clinical stage.(3)There was a good correlation between VCA-IgA,EA-IgA and Rta-IgG.The sensitivity,the The Yorden index and the ROC curve were the best in VCA-IgA and Rta-IgG.The combined tested of the three antibodies was complementary,which can effectively improve the diagnostic rate of nasopharyngeal carcinoma.