Analysis of follow-up results one year after initial screening in high-risk area of nasopharyngeal carcinoma
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摘要:
目的 观察高发区初筛1年后鼻咽癌一级亲属、一般人群血清EB病毒抗体的动态变化及鼻咽癌检出情况。 方法 收集参加2009年8月至2010年7月广东省中山市小榄镇鼻咽癌初筛和2011年8月随访的人群EB病毒血清学资料与鼻咽癌检出情况，比较鼻咽癌一级亲属和一般人群中EB病毒抗体变化及鼻咽癌检出情况。 结果 亲属组NA1/IgA转阴率高于对照组（χ2= 20.28，P＜0.001），且男、女性亲属组分别高于男、女性对照组（χ2=22.59，P＜0.001；χ2=4.03，P＜0.05）；亲属组NA1/IgA转阳率低于对照组（χ2=7.79，P=0.005），男性亲属组高于男性对照组（χ2=9.46，P=0.002），而女性亲属组与女性对照组比较差异无统计学意义（χ2=0.74，P>0.05）。亲属组VCA/IgA转阴率高于对照组（χ2=1.90，P=0.001），男性亲属组高于男性对照组（χ2=7.50，P=0.005），而女性亲属组与女性对照组比较差异无统计学意义（χ2未见表达，P>0.05）。亲属组VCA/IgA转阳率高于对照组，但差异无统计学意义（χ2=0.10，P>0.05）。亲属组未检出新发鼻咽癌，对照组检出10例，对照组鼻咽癌检出率显著高于亲属组，但差异无统计学意义（χ2=1.05，P>0.05）。 结论 EB病毒的变化与遗传因素可能不存在密切联系；初筛后鼻咽癌一级亲属鼻咽癌检出并不高于一般人群，可能无需采取选择性随访原则。 Abstract:Objective To observe the differences in the dynamic change of the EB virus antibody between general population and first-degree relatives (FDR) of nasopharyngeal carcinoma patients during follow-up study one year after initial screening and discuss the difference among the nasopharyngeal carcinoma detections. Methods Serologic data of all subjects that participated in the follow-up study were collected. Changes in EB virus antibodies were investigated and correlation of these changes with gender and age level was analyzed. Differences in the nasopharyngeal cancer detection rate of different populations were also compared. Results NA1/ IgA negative conversion rate was higher in the family group than in the control group (χ2=20.28, P < 0.001). This rate was also higher in both male and female family groups than in the male and female control groups (χ 2=22.59, P < 0.001; χ 2= 4.03, P < 0.05, respectively). NA1/IgA positive conversion rate was lower in the family group than in the control group (χ 2=7.79, P < 0.05). Likewise, this rate was lower in both male and female family groups than in the male and female control groups (χ2=9.46, P < 0.05; χ2=0.74, P=0.39, respectively). VCA/IgA negative conversion rate was higher in the family group than in the control group (χ2=1.90, P < 0.001). This rate was also higher in the male and female family groups than in the male and female control groups (χ2 =7.50, P < 0.05; χ2=no expression, P=0.108, determined by Fish exact test, respectively). VCA/IgA positive conversion rate was higher in the family group than in the control group (χ2=0.10, P=0.70). This rate was again higher in both male and female family groups than in the male and female control groups (χ2= 0.02, P=0.90, χ2=0.51, P=0.48, respectively). Ten cases from the control group manifested nasopharyngeal carcinoma; the same disease was not observed in the family group. Nasopharyngeal carcinoma detection rate was significantly higher in the control group than in the family group, but the difference was not statistically significant (χ 2=1.05, P=0.31). Conclusion a. Reactivation of the EB virus is not closely linked with genetic factors. b. The detection rate of NPC in FDR was lower compared with the general population after initial screening; thus, the rule of selective follow-up is not applicable for FDR. -
Key words:
- nasopharyngeal carcinoma /
- Epstien-Barr virus /
- antibody /
- follow-up /
- first-degree relative
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表 1 随访人群的性别、年龄分布情况
Table 1. Gender and age distribution of population in the follow-up year
表 2 亲属组与对照组NA1/IgA抗体转归的比较
Table 2. Comparison of NA1/IgA change between family and control group
表 3 亲属组与对照组VCA/IgA抗体转归的比较
Table 3. Comparison of VCA/IgA change between family and control group
表 4 10例检出鼻咽癌患者资料
Table 4. Details of 10 detected nasopharyngeal carcinoma patients
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