摘要
目的 探讨血浆EBV-DNA检测联合窄带成像技术(NBI)在鼻咽癌早期诊断中的应用价值。方法 选取2019年4月至2021年4月在我院耳鼻咽喉头颈外科就诊的鼻咽癌(NPC)疑似患者279例为研究对象,取局部黏膜组织行病理学检查,并采用荧光定量PCR检测血浆EBV-DNA水平以及电子鼻咽喉镜普通白光(WLE)模式、窄带成像技术(NBI)模式检查鼻咽部病灶情况。结果 单一检测方法诊断NPC中,WLE模式和NBI模式的灵敏度较EBV-DNA高(P<0.05),NBI模式的特异度、阳性预测值较WLE模式高(P<0.05),EBV-DNA、WLE模式和NBI模式单一诊断NPC的曲线下面积(AUC)分别为0.558、0.649和0.795。联合检测方法诊断NPC中,EBV-DNA联合NBI模式的灵敏度和阳性预测值较EBV-DNA联合WLE模式高(P<0.05),EBV-DNA联合WLE模式、EBV-DNA联合NBI模式诊断NPC的AUC分别为0.694、0.802。结论 EBV-DNA联合NBI模式较EBV-DNA联合WLE和单一方法诊断NPC效能高,能够有效提高诊断灵敏度,减少漏诊率,可在NPC早期诊断中应用和推广。
Objective To explore the application value of plasma EBV-DNA detection combined with narrowband imaging(NBI)in the early diagnosis of nasopharyngeal carcinoma.Methods A total of 279 cases with suspended nasopharyngeal carcinoma(NPC)who were admitted to the department of Otorhinolaryngology head and Neck Surgery of our hospital from April 2019 to April 2021 were enrolled.The local mucosal tissues of all subjects were taken for pathological examination,and plasma EBV-DNA level was detected by fluorescence quantitative PCR,and nasopharyngeal lesions were examined by electronic nasopharyngeal endoscopic normal white light(WLE)mode and narrow band imaging(NBI)mode.Results In the analyses of single index diagnosis,thesensitivity of WLE and NBI models were higher than those of EBV-DNA(P<0.05),and the specificity and positive predictive value of NBI model were higher than those of WLE model(P<0.05).The area under the curve(AUC)of EBV-DNA,WLE and NBI models were 0.588,0.694 and0.795,respectively.In the analyses of combined diagnosis,the sensitivity and positive predictive value of EBV-DNA combined NBI model were higher than those of EBV-DNA combined WLE model(P<0.05).The AUC of EBV-DNA combined WLE model and EBVDNA combined NBI model were 0.694 and 0.802,respectively.Conclusion EBV-DNA combined with NBI model is more effective than single method and EBV-DNA combined with WLE model in the diagnosis of NPC,which can effectively improve the diagnostic specificity and reduce the rate of missed diagnosis,and can be applied and popularized in the early diagnosis of NPC.
作者
覃丽玲
孔令平
林贤俊
赵海云
林高娟
莫规兴
Qin liling;Kong linping;Lin xianjun;Zhao haiyun;Lin gaojuan;Mo guixing(Department of Otolaryngology Head and Neck Surgery,Nanxishan Hospital of Guangxi Zhuang Autonomous Regio,Guilin 541002,China)
出处
《中国医学文摘（耳鼻咽喉科学）》
2023年第4期85-89,99,共6页
Chinese Medical Digest(Otorhinolaryngology)
基金
广西壮族自治区卫健委计划课题(项目编号:Z20190301)。
关键词
鼻咽癌
窄带成像技术
血浆EBV-DNA
早期诊断
Nasopharyngeal carcinoma
Narrowband imaging technology
Plasma EBV DNA
Early diagnosis
