血清P85-Ab与常规实验室指标对鼻咽癌的诊断性能：P85-Ab在多个对照队列中的特异性评估及其与EBV DNA载量的相关性
Diagnostic performance of serum P85-Ab versus routine laboratory indicators for nasopharyngeal carcinoma: specificity assessment of P85-Ab in multiple control cohorts and its correlation with EBV DNA load.
文献信息
| PMID | 42976976 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ya Tao |
| 作者单位 | Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, Hunan Province 410008, China; National Clinical Research Center for Geriatric Diseases (XiangYa Hospital of Central South University), Changsha, Hunan Province 410008, China. |
| 期刊 | Clinica chimica acta; international journal of clinical chemistry |
| SCI 分区 | Q1 |
| IF | 3.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻咽癌 |
中文摘要
目的： 评估血清抗BNLF2b总抗体（P85-Ab）对鼻咽癌（NPC）的诊断价值，并与常规实验室指标进行比较，在多个对照队列中验证其特异性，并探讨P85-Ab水平与Epstein-Barr病毒（EBV）DNA载量之间的相关性。
方法： 我们回顾性纳入中南大学湘雅医院的331名参与者，包括115例NPC患者、46例良性鼻咽疾病患者、118名健康对照者和52名EBV DNA阳性非NPC个体。检测血清P85-Ab水平。收集血常规参数、生化指标和EBV DNA载量。采用受试者工作特征（ROC）曲线分析评估诊断性能。采用DeLong检验比较曲线下面积（AUC）的差异，并进行Spearman秩相关分析以探讨P85-Ab水平与EBV DNA载量之间的关联。
结果： NPC组中P85-Ab阳性率为90.4%（95%置信区间[CI]：83.5%-95.1%），而所有非NPC对照均为阴性，特异性为100%（95% CI：92.3%-100.0%）。P85-Ab的AUC（0.949）显著高于淋巴细胞计数（0.749）、血小板计数（0.668）、球蛋白水平（0.777）（均P < 0.001）及其联合（0.890；P = 0.027）。对三个对照组的分层分析显示P85-Ab的AUC稳定（0.953、0.948和0.947）。尽管EBV DNA阳性非NPC组的中位EBV DNA载量（2120拷贝/mL）约为NPC组（232拷贝/mL）的九倍，但全部52例均为P85-Ab阴性。相关性分析显示，在NPC组（r = 0.050，P = 0.602）或EBV阳性非NPC组（r = -0.021，P = 0.882）内，P85-Ab水平与EBV DNA载量之间均无显著的组内单调关联。
结论： P85-Ab对NPC诊断显示出90.4%（95% CI：83.5%-95.1%）的敏感性和100%（95% CI：92.3-100.0%）的特异性，诊断效能显著优于单个及联合常规实验室指标。未检测到P85-Ab水平与EBV DNA载量之间存在显著的组内单调关联。P85-Ab是一种便捷且可靠的NPC血清学诊断标志物。
英文摘要
OBJECTIVE: To evaluate the diagnostic value of serum anti-BNLF2b total antibody (P85-Ab) for nasopharyngeal carcinoma (NPC) compared with routine laboratory indicators, validate its specificity across control cohorts, and explore the correlation between P85-Ab level and Epstein-Barr virus (EBV) DNA load.
METHODS: We retrospectively enrolled 331 participants from Xiangya Hospital of Central South University, comprising 115 patients with NPC, 46 patients with benign nasopharyngeal diseases, 118 healthy controls, and 52 EBV DNA-positive non-NPC individuals. Serum P85-Ab levels were detected. Routine blood parameters, biochemical indicators, and EBV DNA load were collected. Receiver operating characteristic (ROC) curve analysis was used to assess diagnostic performance. The DeLong test was employed to compare differences in area under the curve (AUC), and Spearman's rank correlation analysis was performed to explore the association between P85-Ab level and EBV DNA load.
RESULTS: The P85-Ab positivity rate in the NPC group was 90.4% (95% confidence interval [CI]: 83.5%-95.1%), whereas all non-NPC controls were negative, yielding a specificity of 100% (95% CI: 92.3%-100.0%). The AUC for P85-Ab (0.949) significantly exceeded those for lymphocyte count (0.749), platelet count (0.668), globulin level (0.777) (all P < 0.001), and their combination (0.890; P = 0.027). Stratified analyses of the three control groups showed stable AUCs for P85-Ab (0.953, 0.948, and 0.947). Although the median EBV DNA load in the EBV DNA-positive non-NPC group (2120 copies/mL) was approximately nine times higher than that in the NPC group (232 copies/mL), all 52 cases were P85-Ab negative. Correlation analyses revealed no significant within-group monotonic association between P85-Ab level and EBV DNA load within either the NPC (r = 0.050, P = 0.602) or EBV-positive non-NPC group (r = -0.021, P = 0.882).
CONCLUSION: P85-Ab demonstrated 90.4% (95% CI: 83.5%-95.1%) sensitivity and 100% (95% CI: 92.3-100.0%) specificity for NPC diagnosis, with diagnostic efficacy significantly surpassing both individual and combined routine laboratory indicators. No significant within-group monotonic association was detected between P85-Ab level and EBV DNA load. P85-Ab represents a convenient and reliable serological diagnostic marker for NPC.