目的：探讨鼻咽癌患者血清EB病毒壳抗原免疫球蛋白A（VCA-IgA）、EB病毒早期抗原-D-IgA抗体（EA-D-IgA）、EA-D-IgG联合检测对于鼻咽癌患者诊断的价值。方法选取60例经病理学确诊的鼻咽癌患者（鼻咽癌组）及60例良性鼻咽疾病患者（良性组），采用酶联免疫吸附法（ELISA）检测血清VCA-IgA、EA-D-IgA、EA-D-IgG，对比两组患者的检出阳性率，并计算相关诊断学效能指标。结果鼻咽癌组血清VCA-IgA、EA-D-IgA、EA-D-IgG抗体阳性率分别为81.67%、50.00%、83.33%，均显著高于良性组的10.00%、5.00%、3.33%，差异均具有统计学意义（P﹤0.01）；血清VCA-IgA鉴别诊断鼻咽癌的灵敏度为81.67%，特异度为86.67%；EA-D-IgA鉴别诊断鼻咽癌的灵敏度为48.33%，特异度为91.67%；EA-D-IgG鉴别诊断鼻咽癌的灵敏度为83.33%，特异度为88.33%；血清VCA-IgA+EA-D-IgA+EA-D-IgG鉴别诊断鼻咽癌的灵敏度为95.00%，特异度为96.67%。结论鼻咽癌患者血清VCA-IgA+EA-D-IgA+EA-D-IgG联合检测对于提高鼻咽癌诊断具有更高的临床价值。%Objective To investigate the significance of combined detection of serum EB virus capsid antigen immu-noglobulin A (VCA-IgA), EB virus early antigen-D-IgA antibody (EA-D-IgA) and EA-D-IgG in the diagnosis of naso-pharyngeal carcinoma (NPC). Method A total of 60 cases of patients with pathologically confirmed nasopharyngeal car-cinoma (NPC group), and another 60 cases of benign nasopharyngeal diseases (benign group) were included in the study, enzyme-linked immunosorbent assay (ELISA) detection was utilized to detect the serum VCA-IgA, EA-D-IgA, EA-D-IgG, and positive rates in the two groups of patients were compared, and relevant diagnostic effectiveness indexes were calculated. Result The serum VCA-IgA, EA-D-IgA, EA-D-IgG antibody positive rates were 81.67%, 50.00% and 83.33%in NPC group, and were significantly higher than that in benign group at 10.00%, 5.00%, and 3.33%, with signifi-cant differences observed (P<0.01);the sensitivity of serum VCA-IgA in differential diagnosis of NPC was 81.67%, and the specificity was 86.67%;while those for EA-D-IgA were 48.33%and 91.67%, and were 83.33%and 88.33%for EA-D-IgG, respectively;besides, the sensitivity of serum VCA-IgA+EA-D-IgA+EA-D-IgG in differential diagnosis of NPC was 95.00%, with specificity being 96.67%. Conclusion The combined detection of serum VCA-IgA+EA-D-IgA+EA-D-IgG is of higher clinical significance in the diagnosis of nasopharyngeal carcinoma.
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