摘要
目的采用EB病毒血清学方法筛查鼻咽癌高、中危人群，并对筛查出的高、中危人群的转归与检出鼻咽癌的关系进行探讨。方法选取2009年8月到2010年7月在广东省中山市某镇鼻咽癌筛查项目中首次血清学鼻咽癌患病风险评估为高、中危的人群为研究对象，通过ELISA联合检测EB病毒衣壳抗原IgA抗体（VCA／IgA）、核抗原IgA抗体（EBNAl／IgA）对首次筛查高、中危人群每年进行1次血清学随访，每次鼻咽癌患病风险评估为高危的人群行鼻咽纤维镜检查。通过3年随访分析高危人群的数量、鼻咽癌检出率以及肿瘤分期的变化。首次筛查检出的鼻咽癌定义为筛查组，随访检出的鼻咽癌为随访组。结果首次筛查高、中危人群1445名，高危404名，中危人群1041名。随访第1、2、3年高危人群的数量逐渐下降依次为371、188和187名。所有高危人群共进行鼻咽纤维镜检查853人次，检出鼻咽癌38例；高危人群的鼻咽癌检出率呈下降趋势，依次为6．2％（25／404）、3．2％（12／371）、0．5％（1／188）、0（0／187）。高、中危人群调查期间累积发病率分别为7．7％（31／404）、0．8％（8／1041）。筛查组与随访组检出的鼻咽癌早诊率均较高，分别为80％（20／25）、11／13。筛查组原发肿瘤以T1期为主（80％，20／25），高于随访组（5／13）（P：0．028）；筛查组区域淋巴结转移率高于随访组，分别为76％（19／25）、5／13（P=0．035）。结论高危人群的鼻咽癌主要在首次EB病毒筛查和第1年随访中检出，之后随访鼻咽癌的检出率急剧下降，鼻咽癌高危人群为筛查中的重点人群。
Objective To investigate the relationship between changes in high-risk populations and screening detected nasopharyngeal carcinoma （NPC） during the three-year follow-up of high-risk and moderate-risk groups at initial EB virus serology screening. Methods We tested EB virus VCA-IgA and EBNAI-IgA antibody to identify the probability of suffering from NPC of the crowd. The high-risk and moderate-risk groups at initial screening in one county during 2009 to 2010 were followed-up once a year with EB virus serology testing. All the high-risk people during initial screening and follow-up were conducted with nasopharyngeal fiber endoscopy. Through the follow-up of three years, we analyzed changes in the number of high-risk group, detection rate of NPC in high-risk group, and tumor staging. Firstly detected NPC by screening was defined as screening group, and detected by following-up was defined as following-up group. Results A total of 404 participants were at high-risk and 1 041 participants were at moderate-risk group, 1 445 persons were in the group. All 404 persons were at high-risk at initial screening, the number of high-risk people during follow-up decreased from 371 to 187,853 people of the all high-risk group were conducted with nasopharyngeal fiber endoscopy, and 38 cases of NPC were detected. NPC detection rate of high-risk group was 6. 2% （25/404）, 3.2% （ 12/371 ）, 0. 5% （1/188） and 0 （0/187） during the initial screening and three years follow-up respectively. The cumulative incidence of NPC in the high-risk and moderate-risk group were 7. 7% （31/404） ,0. 8% （8/1 041 ）. The early diagnosis rate of NPC in screening group and following-up group was 80% （20/25）and 11/13, respectively. With the primary tumor, the rate
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2015年第1期26-30,共5页
Chinese Journal of Preventive Medicine
基金
国家科技支撑计划（2006BA102A11）
中央补助地方卫生专项癌症早诊早治专项资金
关键词
鼻咽肿瘤
早期诊断
EB病毒
筛查
Nasopharyngeal neoplasms
Early diagnosis
Epstain-Barr virus
Mass screening
