POX染色、EBV DNA和EBV IgA抗体在鼻咽癌筛查与诱导化疗前后的对比OA

[Objective]To evaluate the individual and combined diagnostic value of nasopharyngeal mucosal cell POX staining,plasma EBV DNA,and serum EBV IgA antibody for nasopharyngeal carcinoma(NPC)screening,to investigate the relationship between different clinical symptoms and positive detection rates of each indicator,and to compare the changes of each indicator in NPC patients before and after induction chemotherapy.[Methods]A total of 67 patients presenting with nasopharyngeal masses who were treated in the Department of Otorhinolaryngology,the Second Affiliated Hospital of Guangzhou Medical University from September 2022 to January 2025 were prospectively enrolled.All subjects underwent comprehensive evaluation including:POX staining,EBV DNA detection,EBV IgA antibody detection,and nasopharyngeal mass biopsy.According to the pathological results,they were divided into the NPC group(38 cases)and the non-NPC group(29 cases).The diagnostic efficacy of individual detection and their combination of the three indicators during the screening stage was compared between two groups.Clinical symptoms,including neck mass,nasal congestion,regurgitated blood-stained sputum,and bloody nasal discharge,were recorded in the NPC group,and their correlation with detection results was analyzed.For NPC group,the detection results before and after induction chemotherapy were compared in pairs.Normality test(Shapiro-Wilk test)was performed on the measurement data.Data following a normal distribution were presented as"mean±standard deviation",while non-normally distributed data were expressed as"median(IQR)".The Mann-Whitney U test was employed for comparison of non-normally distributed data.Count data were expressed as"cases(%)",and group comparisons was performed using Pearson Chi-Square test,Continuity Correction test,or Fisher ′s exact probability method.Paired categorical data comparison was performed using McNemar test.A P value<0.05 was considered statistically significant.All data analyses were performed using IBM SPSS Statistics 25 and GraphPad Prism 9 software.[Results]During the screening stage,the positive rates of POX staining,EBV DNA,and EBV IgA in the NPC group were 81.6%,34.2%,and 71.1%respectively,which were all higher than those in the non-NPC group(for all indicators except EBV DNA,P<0.05).The sensitivity of the combined detection of the three indicators was 89.5%,which was higher than that of any individual detections;the specificity was 31.0%,which was lower than that of any individual detection.There was no statistically significant difference in the positive rates of each indicator among patients with different clinical symptoms(P>0.05).After induction chemotherapy,the positive rates of POX staining,EBV DNA,and EBV IgA in the NPC group decreased to 28.9%,0.0%,and 36.8%,respectively(all P<0.05).[Conclusion]The combined detection of nasopharyngeal mucosal cell POX staining,plasma EBV DNA,and serum EBV IgA antibody can significantly improve the sensitivity of NPC screening;there is no obvious correlation between the positive rates of each indicator and clinical symptoms.Induction chemotherapy can significantly reduce the positive rates of the three indicators,which is expected to be used as an objective indicator for evaluating short-term therapeutic efficacy.