血清EB病毒抗体水平与鼻咽癌患者预后的关系

目的 探讨血清EB病毒VCA/IgA、EA/IgA、NA1/IgA及Rta/IgG抗体水平与鼻咽癌患者预后的关系.方法 140例初治无远处转移的鼻咽癌患者分别在治疗前和治疗结束后采用免疫酶法检测血清VCA/IgA和EA/IgA,ELISA法检测NA1/IgA和Rta/IgG.随访进行远期疗效和生存的评价.结果 治疗后患者血清VCA/IgA、EA/IgA、NA1/IgA及Rta/IgG抗体水平较治疗前有明显下降,但仍显著高于正常对照组(P＜0.05).治疗后持续缓解的鼻咽癌患者其治疗前VCA/IgA、EA/IgA抗体水平显著低于疾病进展患者(P＜0.05).血清VCA/IgA、EA/IgA、NA1/IgA及Rta/IgG抗体水平与患者的3年总生存率无关(P＞0.05).治疗前VCA/IgA抗体高水平组(≥1∶320)及EA/IgA抗体高水平组(≥1∶80)患者的无进展生存期(61.8％,61.3％)低于抗体低水平组患者(86.5％,86.5％;P＜0.001).Cox回归分析显示治疗前VCA/IgA抗体水平是影响无进展生存的独立危险因素(HR=3.80,P=0.001).结论 VCA/IgA、EA/IgA可为鼻咽癌患者预后判断提供帮助.     

五厂家EB病毒抗体检测试剂盒血清学诊断鼻咽癌的比较

目的 通过比较EB病毒抗体检测试剂盒血清学诊断鼻咽癌的准确性和检测结果的一致性,为试剂盒在临床上的使用选择和性能改进提供依据.方法 使用五厂家的EB病毒衣壳抗原IgA和IgG抗体检测试剂盒（VCA IgA和VCA IgG试剂盒）、核抗原I IgA和IgG抗体检测试剂盒（EBNA1 IgA和EBNA1IgG试剂盒）、早期抗原IgA和IgG抗体检测试剂盒（EA IgA和EA IgG试剂盒）以及Zta IgA抗体检测试剂盒,分别检测33例鼻咽癌患者（NPC）、30例健康体检者（HD）和41例非鼻咽癌的其他肿瘤患者（NNPC）血清或血浆样本.结果 A厂家的VCA IgA试剂盒灵敏度高于其他厂家同品种试剂盒,但对于NNPC特异度最低（36.6％）;而D厂家VCA IgA试剂盒的特异度最高（97.6％）,且对HD的特异度均大于90％.B和D厂家的EBNA1 IgA试剂盒间阳性、阴性符合率分别为92.1％和100.0％.A和E厂家的EA IgA试剂盒的灵敏度均较低而特异度高,试剂盒间阳性符合率低（39.4％）,阴性符合率高（98.6％）;而VCA IgG试剂盒的灵敏度高但特异度低.A和C厂家的EBNA1IgG试剂盒的灵敏度高（100.0％,97.0％）但特异度低（3.3％,13.3％）.C厂家EA IgG试剂盒检测所有样本结果均为阴性.结论 五个不同厂家VCA LgA、EA IgA试剂盒诊断鼻咽癌的准确性和检测结果的一致性存在差异,特别是A厂家和其他国内厂家同品种试剂间差异明显,需根据临床目的进行选择.三家国产VCA IgA试剂盒的灵敏度需进一步提高.相反,EBNA IgA试剂盒诊断鼻咽癌的准确性和结果一致性较好.单独使用VCA IgG和EBNA1 IgG试剂盒血清学诊断鼻咽癌的特异度差,其判读界值可能需根据检测且的进行调整.     

应用基于Logistic回归的ROC曲线评价鼻咽癌EB病毒抗体联合检测

目的 以基于Logistic回归的受试者工作特征(ROC)曲线分析方法,评价VCA/IgA、EA/IgA、Rta/IgG和EBNA1/IgA等EB病毒抗体不同组合在鼻咽癌诊断中的价值.方法 收集211例初治鼻咽癌和203例相似症状的非鼻咽癌病例的血清,采用免疫酶法检测VCA/IgA及EA/IgA,酶联免疫吸附法检测Rta/lgG和EBNA1/IgA.对各种的抗体组合建立Logistic回归模型,以预测概率为分析指标,应用ROC曲线分析,评价不同组合对鼻咽癌的诊断价值.结果 单一指标评价,VCA/IgA敏感度最高(98.1%),EA/IgA特异度最高(98.5%).以基于Logistic同归的ROC曲线分析各项组合,敏感度和特异度均有所提高.双指标组合中,VCA/IgA+Rta/lgG组合的ROC曲线下面积(AUC)为0.991,诊断效能最高,敏感度、特异度及约登指数分别为94.8%、98.0%及0.928.VCA/IgA+Rta/IgG+EBNA1/IgA组合和4项指标组合的敏感度、特异度及约登指数分别为94.8%、98.5%、0.933和96.7%、97.0%、0.937;这两种多指标组合的AUC与VCA/IgA+Rta/IgG组合比较差异均无统计学意义(P＞0.05).结论 基于Logistic回归的ROC曲线分析方法可以为多指标联合诊断试验提供更客观的综合分析,VCA/IgA和Rta/IgG联合检测具有互补作用,是鼻咽癌血清学诊断的合适组合.     

EBV4型IgA/VCA IgA/EA IgG/EA IgG/ZEBRA抗体在鼻咽癌普查和早期诊断中的应用

目的摸索以疱疹病毒4型（EBV）IgG／ZEBRA为捕捉抗原的间接酶联免疫吸附试验（ELISA）条件,为大量人群普查奠定基础。方法将纯化的ZEBRA抗原用于对鼻咽癌（NPC）患者血清及健康人血清IgG／ZEBRA抗体的ELISA检测。结果检测NPC患者血清288份,其中ELISA实验显示阳性262份,敏感度91％,检测正常人血清96份,其中阳性5份,特异度94．8％。其结果显示NPC组的阳性率与健康对照组的数据之间差异有统计学意义（P〈0．001）。本研究在此基础上对广东惠州5463份和广西桂平2017份血清进行检测,检出早期鼻咽癌患者5例。并将结果与免疫酶法检测IgA／VCA、IgA/EA、IgG／EA比较。结论以EBV早期抗原ZEBRA为捕捉抗原的间接ELISA方法具有较高的特异性和敏感性,可以用于大量人群的NPC早期筛查和早期诊断。     

EB病毒两种抗体联合检测在鼻咽癌诊断中的应用

目的探讨EB病毒（epstein—barr virus,EBV）抗体在鼻咽癌早期诊断中的应用价值。方法采用酶联免疫吸附试验（ELISA）测定53例鼻咽癌患者、71例鼻部疾病患者和40例正常体检人群血清EBV相关抗体（EBV VCA—IgA和EA—IgA）。结果3组比较,鼻咽癌组血清VCA—IgA的阳性检出率为79．2％,EA-IgA阳性率为50．9％,与其余两组比较差异有统计学意义（P〈0．01）;鼻咽癌组和鼻部疾病组内VCA-IgA和EA-IgA的阳性率比较差异有统计学意义（P〈0．01）;检测鼻咽癌组两项指标的吸光度均值较另两组高;VCA-IgA单独检测及两项联合检测均具有较高的敏感性（79．2％）,EA-IgA单独检测及两项联合检测均具有较强的特异性（93．8％）。结论联合检测鼻咽癌病人血清的VCA—IgA和EA—gA可兼具两者的性能优势,敏感性较高,特异性较强。对鼻咽癌的早期诊断具有重要的临床应用价值。     

制备醛固酮多克隆抗体建立检测血浆醛固酮的化学发光免疫分析法

目的：制备可用于免疫分析的醛固酮(ALD)多克隆抗体,并建立基于生物素-链霉亲和素放大系统的ALD化学发光免疫分析方法,用于测定人血液中的ALD含量。 方法：对ALD进行化学改造,制备醛固酮肟,再与BSA偶联制备免疫原,免疫兔,制备抗ALD多克隆抗体。以生物素-链霉亲和素放大系统采用竞争法建立ALD化学发光免疫分析方法。结果：经检测免疫的3号兔获得的抗ALD抗体灵敏度最高,50%抑制率（IC₅₀）ALD浓度是268 pg/ml。用该抗体建立的化学发光免疫分析法的检测范围为62.5~2 000 pg/ml,灵敏度为 23.7 pg/ml,批内变异系数为6.9%~9.5%,批间变异系数为8.5%~12.7%,回收率范围为93.1%~104.1%,稀释实验测定值与理论值呈线性相关,相关系数为r=0.996,与放射免疫分析试剂盒的相关性方程分别为y=0.932x+4.596,相关系数r=0.948（n=95）。结论：建立的检测ALD的化学发光免疫分析法符合临床应用的基本要求。     

EB病毒胸腺嘧啶激酶抗体在鼻咽癌血清学诊断中的作用

目的 建立EB病毒感染和鼻咽癌血清学检测的敏感,特异和有效的方法.方法 以EB病毒早期蛋白胸腺嘧啶激酶为检测抗原,建立ELISA和免疫纤维膜条方法,检测血清中的特异性的IgG抗体.结果 用ELISA和诊断条同时检测了401份血清,其中鼻咽癌患者血清127份.两种方法检测鼻咽癌患者血清抗体均阳性,274份门诊患者血清中,55份ELISA和诊断条检测抗体均阳性,3份诊断条方法检测阳性的血清,ELISA检测A值接近临界值.对胸腺嘧啶激酶的抗体阳性率明显地高于早期蛋白P54.结论 以胸腺嘧啶激酶为检测抗原,为鼻咽癌血清学诊断和高危人群的筛查提供更有效的手段.     

人血清生长激素化学发光免疫分析方法的建立

建立链霉亲和素-生物素双抗体夹心化学发光免疫分析法(CLIA)测量人血清生长激素(GH),并进行临床应用检测.以链霉亲和素包被微孔板,生物素化一株GH单克隆抗体(McAb),辣根过氧化物酶标记另一株McAb,校准品与国家标准品进行溯源,建立GH CLIA法,进行性能参数测试,与国外试剂盒比对.结果表明本法线性范围为2....     

人心肌肌钙蛋白T胶体金免疫层析法的建立

目的 建立一种简便,快速,准确检测人心肌肌钙蛋白Ｔ（ｃＴｎＴ）的胶体金免疫层析法（ＧＩＣＡ）。方法 制备的胶体金标记抗ｃＴｎＴ单克隆抗体３Ｆ７,生物素标记另一株抗体２Ｈ８,链霉亲和素结合于硝酸纤维素膜上,制成免疫层析试纸条,血清中ｃＴｎＴ与测试条两种抗体结合后,沿硝酸纤维素膜移动,与链霉亲和素交联形成肉眼可见的红色线条。结果 测试条灵敏度可达０．５ｎｇ／ｍｌ。检测３０例急性心肌梗塞（ＡＭＩ）患者血     

estern印迹杂交分析p53蛋白在人鼻咽癌中的表达及其意义

目的 :检测 10 4例鼻咽癌活检组织和 8例鼻咽粘膜慢性炎症组织中p5 3蛋白的表达。方法 :采用Western印迹法结合免疫沉淀技术。结果 :10 4例鼻咽癌活检组织中有 12例出现突变型p5 3蛋白表达 ,突变检出率为 11.5 4% (12 10 4) ;8例鼻咽慢性炎症活检组织中未见p5 3蛋白的异常表达 (0 8) ;鼻咽癌病人中人IgA VCA抗体滴度≥ 1∶16 0者 ,p5 3蛋白突变检出率为11.80 % (11 93) ,IgA VCA抗体滴度≤ 1∶80者 ,p5 3蛋白突变检出率为 9.10 % (1 11) ,IgA EA抗体滴度阳性者 ,p5 3蛋白突变检出率为 14.10 % (11 78) ,IgA EA抗体滴度阴性者 ,p5 3蛋白突变检出率为 3.80 % (1 2 6 ) ;12例p5 3蛋白异常表达的鼻咽癌病人中有 2例复发。结论 :突变型p5 3基因产物的表达与鼻咽癌EB病毒早期抗原有关 ,p5 3基因在鼻咽癌中可能发挥一定的作用     

Improved sensitivity of detection by avidin-biotin complex (ABC) immunocytochemistry in Epstein-Barr virus serology

Serum antibodies against Epstein-Barr virus (EBV)-determined antigens have traditionally been titrated by the indirect immunofluorescence (IIF) technique. The avidin-biotin complex (ABC) immunocytochemical technique was used to determine the serum levels of IgA against EBV viral capsid antigen (IgA/VCA) and IgA against EBV early antigen (IgA/EA) in sera of 106 nasopharyngeal carcinoma (NPC) patients prior to treatment and 100 normal individuals. The sensitivity of the ABC technique is enhanced by an amplification of the antigen-antibody reaction, which involves the binding of the enzyme-linked ABC to the second biotinylated antibody. There was a good correlation (r = 0.9988) between ABC and IIF-determined IgA/VCA-positive titres, with the ABC technique being more sensitive than IIF in the detection of IgA/VCA in NPC sera: 94% (99/106) and 76% (80/106), respectively. The frequency of IgA/EA reactivity in NPC sera was also markedly increased by immunodetection with the ABC technique as compared with IIF technique: 63% (69/106) and 28% (30/106) respectively. Both the immunocytochemical techniques were equally specific in discriminating between elevated serum titres of IgA/VCA and IgA/EA in NPC sera from normal human sera.     

用基因工程表达的抗原早期诊断鼻咽癌

目的为了建立鼻咽癌（ＮＰＣ）早期诊断方法。方法以基因工程表达的、经纯化的ＥＢ病毒（Ｅｐｓｔｅｉｎ－Ｂａｒｖｉｒｕｓ，ＥＢＶ）早期抗原（ＥＡ）成分ＥＡ－Ｄ和ＥＡ－Ｒ作为诊断抗原，建立了酶联免疫吸附试验（ＥＬＩＳＡ），检查３０例ＮＰＣ病人及４９例正常人血清中的ＥＡ／ＩｇＡ抗体。结果用ＥＬＩＳＡ检测抗体较用细胞涂片免疫酶方法（ＩＥ）敏感。ＥＬＩＳＡ检测ＮＰＣ病人血清中ＥＡ／ｌｇＡ抗体，阳性率为１００％，ＥＡ／ｌｇＡ抗体效价均≥１∶１００。而用ＩＥ法，平行检测３０例ＮＰＣ病人血清中ＥＡ／ｌｇＡ抗体效价，结果６例为阴性（＜１∶１０），抗体阳性率为７０％。ＥＬＩＳＡ明显地提高了ＮＰＣ的检出率。以ｐ１３８（ＥＡ－Ｒ）和ｐ５４（ＥＡ－Ｄ）分别或混合包被，检测对ＥＢＶ特异的ＥＡ－Ｄ和ＥＡ－Ｒ的抗体。结论表明在ＮＰＣ病人血清中存在对ＥＡ两种抗原的抗体，对ＥＡ－Ｄ的抗体滴度高于对ＥＡ－Ｒ的抗体。因此，以两种抗原混合包被作为诊断抗原建立的ＥＬＩＳＡ方法，为ＮＰＣ的早期诊断提供更敏感、特异和简便的手段。     

Detection of IgA antibodies to Epstein-Barr virus-associated antigens by ELISA

The detection of IgA antibodies to the Epstein-Barr virus (EBV)-associated viral capsid antigen (VCA) and early antigens (EA) is of diagnostic and prognostic importance for patients with nasopharyngeal carcinoma (NPC). An ELISA for the determination of serum IgG antibodies to these antigens has been developed which uses the double antibody method. 136 sera obtained from healthy donors and patients with non-EBV related tumors and lymphomas were tested by ELISA; only 3 sera, from patients with chronic lymphatic leukemia, hairy cell leukemia and Burkitt-like lymphoma, contained antibodies of IgA class to VCA and EA. Ninety-five sera from patients suspected of having NPC were tested. IgA anti-VCA was found in 28 sera (29.5%), 12 of which also contained IgA anti-EA. The assays described are suitable for diagnosis and follow-up of patients with EBV-associated nasopharyngeal carcinoma. Furthermore, isolated EA components may be tested for their reactivity with IgA antibodies, as was shown for the 60 kDa polypeptide associated with the EA complex.     

An immunoperoxidase assay for the detection of specific IgA antibody in Epstein-Barr virus infections.

A technique using indirect immunoperoxidase antibody was developed for the detection of specific serum IgA antibody to Epstein-Barr virus capsid antigen and early antigen. The IgA technique was compared with an immunofluorescence antibody method. Epstein-Barr virus IgA antibody against viral capsid antigen was detected in all nine patients with Epstein-Barr virus associated undifferentiated nasopharyngeal carcinoma, in 13 (72.2%) of 18 patients with infectious mononucleosis, in 21 (28.3%) of 74 patients with acute lymphoblastic leukaemia, and in six (20%) of 30 patients who had recently had kidney transplants. Epstein-Barr virus IgA antibody against viral capsid antigen was also detected in four (10%) of 40 healthy subjects, but it was not found in any of 20 cord blood samples. Epstein-Barr virus IgA antibody to early antigen was detected in six (66.6%) patients with nasopharyngeal carcinoma and in two (2.7%) patients with acute lymphoblastic leukaemia. The immunoperoxidase assay for Epstein-Barr virus specific IgA was simple, reliable, and rapid and correlated well (r = 0.94) with the immunofluorescence antibody technique.     

Rapid and sensitive immunomagnetic-electrochemiluminescent detection of p53 antibodies in human serum

The mutation of tumor suppressor p53 gene is common in malignant tumor. p53 antibodies are products of immunoresponse against abnormal p53 protein. It has been found that p53 antibodies are of importance in tumor's diagnosis, prognosis and relapse monitoring. However, current method for detecting p53 antibodies, i.e. enzyme-linked immunosorbent assay (ELISA), requires a long time with multiple steps, and the assay is only semi-quantitative. In this work, a protocol for quantitative detection of p53 antibodies in human serum using immunomagnetic electrochemiluminescence (IM-ECL) was devoloped. The immunoassay format consisted of a three antibody sandwich in which a biotinylated capture antibody, was banded with the commercial p53 protein. A detector antibody was added to bind the p53 protein at another site. Then, secondary antibody, labeled with ruthenium(II) tris-bipyridal, was added and, when bound to the bead immunocompiex, generated light in the presence of an excess of tripropylamine. The light was detected and measured by the analyzer made by us. Our experimental results indicate that the sensitivity of this assay was 10 pg of p53 antibodies per ml of reference serum (normal human serum). A stable calibration curve with a wide dynamic range was established. The calibration curve was linear from 0.01 to 1000 ng/ml, thus, making quantitation possible. An immunologic prozone effect was observed above 1000 ng p53 antibodies per milliliter of serum. Serum samples from lung and nasopharyngeal carcinoma patients were tested using the IM-ECL assay. The positive rate of p53 antibodies were 28.6% in lung carcinoma and 8.33% in nasopharyngeal carcinoma, respectively. p53 antibody concentration in the carcerous human sera were quantified from the calibration curve. In the case of lung carcinoma, a trend was found that a higher p53 antibody concentration in the serum was likely linked to a higher stage of the cancer. This trend was not found in nasopharyngeal carcinoma. The assay uses only 50 microl of sample per test and requires a 30-min incubation period in addition to a 50 s acquisition time. This assay has several advantages over the commonly used ELISA method in terms of sensitivity, linear range, and assay time. Results of the study suggest that IM-ECL is a feasible method for rapid and sensitive detection of p53 antibodies in human serum.     

Detection of IgA antibody to EBV membrane antigen using Staphylococcus aureus preabsorbed sera is closely associated with nasopharyngeal carcinoma

The presence of IgA antibody to membrane antigen (MA) of Epstein-Barr virus (EBV) was tested in sera from 48 nasopharyngeal carcinoma (NPC) patients, 40 patients with tumors other than NPC and 46 normal individuals. The sera were preabsorbed with Staphylococcus aureus (SPA) (strain no. 1800) prior to their use in the indirect immunofluorescence test. One hundred percent of the NPC patients had the IgA/MA antibody with a GMT of 1:141. In patients with tumors other than NPC or normal individuals, IgA/MA antibodies were not detectable. The IgA/MA antibodies have been demonstrated in 6 NPC patients lacking detectable antibody levels in the indirect immunofluorescence test using nonabsorbed sera. Our data indicate that preabsorbtion of sera with SPA renders the diagnostic test significantly more sensitive for the detection of the nasopharyngeal carcinoma and can be used for trials on the prognosis of patients.     

Epstein-Barr病毒壳抗原gp125的纯化和应用

目的研制ｅｐｓｔｅｉｎ－Ｂａｒ（ＥＢ）病毒诊断试剂。方法将重组痘苗病毒表达的Ｅｐｓｔｅｉｎ－Ｂａｒ病毒（ＥＢＶ）壳抗原（ＶＣＡ）主要多肽ｇｐ１２５纯化，作为诊断抗原建立了酶联免疫吸附试验（ＥＬＩＳＡ），检测了４８份鼻咽癌（ＮＰＣ）病人血清及１０份正常人血清中的ＶＣＡ／ＩｇＡ抗体。结果该方法与免疫荧光（ＩＦ）检测结果一致，但ＥＬＩＳＡ的平均几何滴度（ＧＭＴ）是ＩＦ的１２倍。结论以纯化的ＥＢ病毒壳抗原主要多肽ｇｐ１２５作为诊断抗原建立的检测方法，更适合于ＥＢＶ相关疾病的血清学诊断和血清流行病学调查。     

IgA antibodies against the Epstein‐Barr nuclear antigen1 as a valuable biomarker for the diagnosis of nasopharyngeal carcinoma in Tunisian patients

Serological tests for Epstein‐Barr virus (EBV) have been used for many years as diagnostic predictors of nasopharyngeal carcinoma. It has been shown previously that the conventional immunofluorescence assay has a limited diagnostic value, especially in young patients from North African area. In the search for more reliable immunoglobulin (Ig) G or IgA antibody markers for the diagnosis of nasopharyngeal carcinoma, immunoblot analysis was performed using a full spectrum of EBV proteins. Sera were collected from 108 patients with nasopharyngeal carcinoma and three control groups composed of 18 patients with lymphoma, 18 other patients with autoimmune diseases and 55 healthy EBV carriers. It was observed that the IgA Epstein‐Barr nuclear antigen 1 (EBNA1), IgA early antigen (EA)‐p138 and IgG EA‐p138 antibodies represent the most specific anti‐EBV responses in either young or older patients with nasopharyngeal carcinoma which yield higher positive rates compared to the three control groups. Since the IgA EBNA1 response showed the highest sensitivity value for the detection of nasopharyngeal carcinoma, a novel enzyme‐linked immunosorbent assay (ELISA) was established using a GST‐EBNA1 protein expressed in bacteria, containing the P‐threonine EBNA1 subtype cloned from DNA EBV sequence of C15 xenograft cells. Detection rates were 85.7% and 94.9% in young and older patients with nasopharyngeal carcinoma respectively, while only 3.6%, 11.1%, and 16.6% in healthy EBV carriers, patients with lymphoma and patients with autoimmune diseases, respectively. Thus, IgA EBNA1 ELISA may be useful for early diagnosis and mass screening of nasopharyngeal carcinoma in Tunisia even in young patients. J. Med. Virol. 81:1412–1421, 2009. © 2009 Wiley‐Liss, Inc.