四会市筛查人群中鼻咽癌患者长期生存状况分析  

Analysis of the Long-term Survival of Nasopharyngeal Carcinoma Patients in a Population-based Screening in Sihui City

作　　者：刘科[1] 陈峰[2] 黄启洪 李艳华[3] 曹素梅[1,2] 

机构地区：[1]中山大学肿瘤防治中心鼻咽科华南肿瘤学国家重点实验室,广州市510060 [2]中山大学肿瘤防治中心临床试验研究中心 [3]广东省四会市肿瘤研究所

出　　处：《中国肿瘤临床》2011年第11期630-633,共4页Chinese Journal of Clinical Oncology

基　　金：国家科技支撑计划项目(编号:2006BAI02A11)资助~~

摘　　要：目的：通过比较广东省四会地区参加与未参加筛查人群中鼻咽癌（nasopharyngeal carcinoma）患者的长期生存率,评价运用EB病毒血清抗体指标筛查鼻咽癌的远期效果.方法：对鼻咽癌高发区广东省四会市江谷镇、地豆镇30～59岁健康人群共17 786例运用以检测血清抗EB病毒抗体VCA-IgA、EA-IgA为主的筛查方案进行鼻咽癌筛查,全部人群按实际参加情况分为参加筛查组（10 665例）和未参加筛查组（7 121例）,随访至2007年12月,记录鼻咽癌的发生和死亡情况.运用Log-rank检验比较2组人群中检出鼻咽癌患者的长期生存率.结果：参加筛查组和未参加筛查组鼻咽癌患者的10年总生存率分别为38%和18%（χ2=4.408,P=0.036）;早诊率分别为55.1%和31.0%（χ2=4.727,P=0.030）,前者均明显优于后者.结论：本研究提示在中国南方鼻咽癌高发区开展以EB病毒血清抗体检测为主的鼻咽癌筛查能提高检出鼻咽癌患者的长期生存率,其生存率提高的主要原因为筛查提高了检出鼻咽癌患者的早诊率.Objective： To evaluate the long-term effects of screening nasopharyngeal carcinoma （ NPC ） with Epstein - Barr viral （ EBV ） serological antibody tests by comparing the long-term survival rates of NPC participants and nonparticipants in a mass screening in Sihui City. Methods： The target population （ 17,786 ）, with an age range of 30 to 59 years, from Didou and Jianggu Towns of Si- hui City, the high-risk area, were invited to participate in a NPC mass screening in 1992. Serological tests were performed with IgA antibodies against the EBV capsid antigen （ VCA/IgA ） and the early antigen （ EA/IgA ）. All subjects （ 17,786 ） were divided into two groups, namely, the participants （10, 665） and the nonparticipants （ 7, 121 ） based on the population screening. The follow-upended in December 2007, recording the incidence and deaths from NPC. A log-rank test was conducted to compare the long-term survival rates of the NPC patients between the two groups. Results： The 10-year overall survival rate of NPCs among participants and nonparticipants was 38% and 18%, respectively （ x2 = 4.408, P = 0.036 ）. The rate of early diagnosis for NPCs was 55.1% and 31% in the two groups, respectively （ x2= 4.727, P = 0.03 ）. The former is apparently superior to the latter. Conclusions： Screening for NPC using EBV serological antibody tests as the first line of screening in high-risk area of southern China can improve the long-term survival rate of patients. Screening can improve the early diagnosis rate in the participants, which is critical for longer survival rates of NPC patients.

关 键 词：鼻咽癌 筛查 长期生存 早期诊断 

分 类 号：R739.63[医药卫生—肿瘤]