The Detections Of EBV-VCA-IgA, EBV-EA-IgA And EBV-Rta-IgG In Diagnosis Of Nasopharyngeal Carcinoma

Object: To compare the performances of EBV-VCA-IgA, EA-IgA and Rta-Ig G in the diagnosis of nasopharyngeal carcinoma, and find the most accurate combined detection scheme. The relationship between the Rta-Ig G level and the staging of nasopharyngeal carcinoma was also assessed.Methods: 96 patients presenting with nasopharyngeal carcinoma pathologically verified by electronic laryngoscope to the Fujian Medical University Union Hospital between July 2012 and February 2015 were studied as the case group. And the normal healthy individuals who detected EBV-VCA-IgA, EA-IgA and Rta-Ig G at the same period was studied as the control group. In the case group, 94 patients had detailedly information documented in the notes on the clinical features and the staging of nasopharyngeal carcinoma, and 54 patient re-detected the VCA-IgA, EA-IgA and Rta-Ig G after treatment. Comparisons were performed by the Fisher’s exact, z test and the Student’s t test. Statistical significance was considered at p < 0.05.Results: The analysis included a total of 346 cases. 74 subjects were nasopharyngeal carcinoma cases and the remaining 174 subjects were normal healthy individuals.The sensitivities of EBV-VCA-IgA, EA-IgA and Rta-Ig G were 0.885, 0.490 and 0.656, individually. The specificity of VCA-IgA, EA-IgA and Rta-Ig G were 0.888, 0.960 and 0.952, individually.The diagnostic accuracy of EBV-VCA-IgA was significantly higher than it of EA-IgA and Rta-Ig G(p<0.05). Based on the VCA-IgA, we performed 3 combined detection schemes: VCA-IgA+EA-IgA, VCA-IgA+Rta-Ig G and VCA-IgA+EA-IgA+Rta-Ig G. The differences betweem the diagnostic results of the 3 combined detection schemes and the diagnostic result of VCA-IgA had no statistical significance(p>0.05). However, all of the 3 combined detection schemes had higher sensitivity then VCA-IgA, and the sensitivity of VCA-IgA+EA-IgA+Rta-Ig G was highest. Best cutoff points of VCA-IgA, EA-IgA and Rta-Ig G calculated by ROC curve analyses were 1.37s/co, 0.706s/co and 0.817s/co, individually. There 96 nasopharyngeal carcinoma patients had significantly higher Rta-Ig G OD than the healthy individuals(p<0.01). But there was no significant significant correlation between serum Rta-Ig G levels and the staging of nasopharyngeal carcinoma. Rta-Ig G OD of 54 nasopharyngeal carcinoma patients before and after treatment were 3.681±0.442 and 3.031±0.409 individually and do not have statistical difference(p>0.05).Conclusion: We suggested that:(1)EBV-VCA-IgA, EA-IgA and Rta-IgG were all helpful indicators in the diagnosis of nasopharyngeal carcinoma. And VCA-IgA was more accurate than the other ones.(2)Combined detection scheme was helpful in raising sensitivity. Furthermore, the sensitivity of VCA-IgA+EA-IgA+Rta-Ig G was highest.(3) In order to make the detection more closely related to the clinical characteristics of local patients, the normal reference ranges of VCA-IgA, EA-IgA and Rta-Ig G could be adjusted based on the a certain amount of samples. VCA-IgA, EA-IgA and Rta-Ig G were all tend to be more accurate after the normal reference ranges were adjusted. However, the diagnostic accuracy of combined detection schemes did not increase with the adjusted reference ranges.(4)Rta-Ig G OD of nasopharyngeal carcinoma patient was significantly higher than it of healthy individuals, but there was no significant correlation between serum Rta-Ig G levels and the staging of nasopharyngeal carcinoma. There was no statistical difference between the Rta-Ig G OD of nasopharyngeal carcinoma patients before and after treatment.