DOI：10.19368/ki.2096-1782.2023.06.028EB-IgA联合NBI内镜检查在鼻咽癌筛查中的临床应用研究韦善文，谭柳春，吴婷玲，李健河池市人民医院耳鼻咽喉科，广西河池547000[摘要]目的探究EB病毒抗原免疫球蛋白A（EB-IgA）联合内径窄带成像术（narrow band imaging, NBI）在鼻咽癌筛查中的临床应用价值。
方法选取2020年12月—2022年12月于河池市人民医院就诊的以涕中带血、耳闷堵感、听力下降等为主诉的521例患者为研究对象。
分别对其开展EB-IgA及NBI内镜检查，以病理检查结果为参照标准。
比较EB-IgA、NBI和EB-IgA+NBI三种技术对鼻咽癌筛查价值的差异。
结果 EB-IgA筛选出鼻咽癌患者61例、非鼻咽癌患者236例；灵敏度为70.11%、特异度为54.38%、准确度为57.01%、阳性预测值为23.55%。
NBI筛选出鼻咽癌患者72例、非鼻咽癌患者362例；灵敏度为82.76%、特异度为83.41%、准确度为83.30%、阳性预测值为50.00%。
EB-IgA+NBI筛选出鼻咽癌患者83例、非鼻咽癌患者405例，灵敏度为95.40%、特异度为93.32%、准确度为93.67%、阳性预测值为74.11%。
EB-IgA+NBI鼻咽癌诊断的灵敏度、特异度、准确度、阳性预测值高于NBI及EB-IgA，差异有统计学意义（P<0.05）。
结论 NBI有助于更好地观察到黏膜表面细微结构的变化，其在鼻咽癌筛查中的诊断价值要优于EB-IgA，但如能够将EB-IgA同NBI检测联合起来，则可以明显提高鼻咽癌筛查的准确率，建议临床上选择两种方式联合筛查作为鼻咽癌初筛手段。
[关键词]EB病毒抗原免疫球蛋白A；内径窄带成像术；鼻咽癌[中图分类号]R73 [文献标识码]A [文章编号]2096-1782（2023）03(b)-0028-04Clinical Application of EB-IgA Combined with NBI Endoscopy in the Screening of Nasopharyngeal CarcinomaWEI Shanwen, TAN Liuchun, WU Tingling, LI JianDepartment of Otorhinolaryngology, Hechi People's Hospital, Hechi, Guangxi Zhuang Autonomous Region, 547000 China[Abstract] Objective To explore the clinical application value of Epstein-Barr virus antigen immunoglobulin A (EB-IgA) combined with narrow band imaging (NBI) in nasopharyngeal carcinoma screening. Methods From December 2020 to December 2022, 521 patients treated in Hechi People's Hospital who complained of blood in nose, ear block⁃age and hearing loss were selected as research objects. EB-IgA and NBI endoscopy were performed respectively, and pathological examination results were used as the reference standard. To compare the screening values of EB-IgA, NBI and EB-IgA+NBI for nasopharyngeal carcinoma. Results 61 patients with nasopharyngeal carcinoma and 236 pa⁃tients without nasopharyngeal carcinoma were screened by EB-IgA. The sensitivity was 70.11%, specificity 54.38%, accuracy 57.01% and positive predictive value 23.55%. NBI screened out 72 patients with nasopharyngeal carcinoma and 362 patients without nasopharyngeal carcinoma. Sensitivity was 82.76%, specificity was 83.41%, accuracy was 83.30% and positive predictive value was 50.00%. EB-IgA+NBI screened 83 patients with nasopharyngeal carcinoma and 405 patients without nasopharyngeal carcinoma. The sensitivity was 95.40%, specificity was 93.32%, accuracy was 93.67% and positive predictive value was 74.11%. The sensitivity, specificity, accuracy and positive predictive value of EB-IgA+NBI in diagnosis of nasopharyngeal carcinoma were higher than those of NBI and EB-IgA, and the [基金项目]河池市科技计划项目（河科AB200701）。
