BACKGROUND & OBJECTIVE: The aim of this study was tooptimize a dual-antibody assay for sero-diagnosis of nasopharyngeal carcinoma(NPC) by evaluating 4 Epstein-Barr virus(EBV) antigen-based enzyme-linkedimmunosorbent assays(ELISAs). METHODS: The serum samples of 57pretreated NPC patients and 58 apparently healthy adults in Guangzhou werecollected. The levels of anti-EBV antibody in the sera were tested by 4 ELISAs,which were developed using fusion proteins of glutathione transferase and EBVspecific recombinant antigens, namely, EBNA1-IgA, EBNA1-IgG, Zta-IgA, andZta-IgG. RESULTS: When evaluated individually, the sensitivity(0.9123) andnegative predictive value(0.9074) of EBNA1-IgA were the highest among the 4ELISAs tested. Zta-IgA test had the highest individual accuracy rate(n, 0.8870)and Youden index(J, 0. 7738) . The dual positives for EBNA1-IgA and Zta-IgAwere the highest among the 4 dual positives when paired ELISAs were evaluated.Five NPC patients with negative reaction to EBNA1-IgA showed positive reactionof Zta-IgA, and 7 NPC patients with negative reaction to Zta-IgA showed positivereaction of EBNA1-IgA. CONCLUSION: The EBNA1-IgA assay is more suitablethan the other 3 ELISAs(EBNA1-IgG, Zta-lgA, and Zta-IgG) when usedindividually for serological diagnosis of NPC. When two assays are combined,EBNA1-IgA and Zta-IgA have complementary effect on serological diagnosis forNPC and is thus an optimal combination of serum antibody assays.%背景与目的:在评估4种EB病毒抗原酶联免疫吸附法的基础上,探讨优化抗重组EB病毒抗原双重抗体检测应用于血清学诊断鼻咽癌.方法:收集广州地区57例治疗前鼻咽癌患者和58例健康成人的血清.应用EB病毒特异抗原(谷胱甘肽转移酶重组融合蛋白)为基础的4种免疫酶联吸附法,即EBNA1-IgA,EBNA1-IgG,Zta-IgA和Zta-IgG检测血清中抗EB病毒的抗体水平.结果:EBNA1-IgA的灵敏度(0.9123)和阴性预测值(0.9074)是单独使用4种ELISA实验中最高的.Zta-IgA具有最高的正确率(n,0.8870)和Youden指数(J,0.7738).当评估配对的ELISA时,EBNA1-IgA和Zta-IgA双重阳性的所有指标是4种双重阳性实验中最高的.5例EBNA1-IgA阴性的鼻咽癌患者呈Zta-IgA阳性,而7例Zta-IgA阴性的鼻咽癌患者呈EBNA1-IgA阳性.结论:EBNA1-IgA酶联免疫吸附的单独检测在血清学诊断鼻咽癌时优于其他3项(EBNA1-IgG、Zta-JgA 和Zta-IgG)单独酶联免疫吸附检测.EBNA1-IgA和Zta-IgA两项的组合应用在血清学诊断鼻咽癌时有互补作用,是血清学检测的合适组合.
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