Clinical Application Value Of FH Detection And EB Virus Antibodies Serological Detection For Screening Of Nasopharyngeal Carcinoma

Objective:By conducting a prospective research about diagnosis of nasop haryngeal carcinoma with Cells free ferrous protoporphyrin(FH)dete ction,to investigate the clinical value of FH detection and Epstein-Barr virus(EBV)antibodies serological detection for the screening of nasop haryngeal carcinoma.Method:A total of 220 suspicious patients with nasopharyngeal carci noma from October 2018 to December 2019 in the Hunan Provincial People's Hospital were detected by FH detection and EBV antibodies serological detection.The gold standard is the result of nasopharyngeal mass biopsy.Analyzing the evaluation of each diagnostic detection sepa rately and jointly,such as the possibility of missed diagnosis and misd iagnosis,the accuracy of the diagnostic detection,and the consistency of the detection.Then constructing the Receiver Operating Charact eristic(ROC)curve.Result:A total of 220 suspicious patients,36 of whom were diagnosed as nasopharyngeal carcinoma by pathological biopsy.The difference of EBVCA-IgG and pathological biopsy was no statistical significance(P<0.05).Although EB-NA-IgA antibody(97.8%)and EB-VCA-IgA ant ibody(98.4%)have high specificity and were not easy to misdiagnose,but both of them had low sensitivity(72.2% vs 66.7%).It is easy to cause mi ssed diagnosis.The low Youden index(70.1% vs 65.0%)showedpoor authenticity.However,the Youden index of Rta-IgG antibody(92.8%)and FH detection(89.6%)were higher,which the sensitivity(94.4% vs 97.2%)and specificity(98.4% vs 92.4%)reached the maximum level.The area under the ROC curve of Rta-Ig G antibody and FH detection are 0.964(95% CI:0.919-1.000,P<0.001),0.948(95%CI : 0.910-0.987,P<0.001),respectively.The joint detection of FH detection and 3 EBV antibodies(EB-Rta-IgG,EB-VCA-Ig A,EB-NA-IgA)was sensitive to naso pharyngeal carcinoma because of the highest area under the ROC curve(0.982,95% CI: 0.949-1.000,P<0.001).When this 4 tests combined together,the sensitivity was94.4%,the specificity increased to 99.5%,the Youden index increased to93.9%.The diagnostic efficacy of single detection was not as resultful as the combined detection.It can also be found from the ROC curve that the diagnostic efficacy of EBV Rta-IgG and FH detection was close to the diagnostic efficacy of combined 4 detection.Conclusion:The EB virus Rta-IgG serological detection combined with the nasopharyngeal Cells free ferrous protoporphyrin(FH)detection has a high sensitivity,specificity and accuracy for the diagnosis of early naso pharyngeal carcinoma,and the method is simple,convenient and suitable for clinical application.