广西五地区25万自然人群EB病毒VCA-IgA联合EBNA1-IgA鼻咽癌筛查结果分析  

Application of EBV VCA-IgA combined with EBNA1-IgA in screening nasopharyngeal carcinoma in 250000 natural population in Guangxi five regions

作　　者：江旭 夏巍 李学华 赖永静 李禄 谭颂华[1] 何光耀[1] 谢貌[1] 李静雨[1] 唐安洲[1] 易翔[1] JIANG Xu;XIA Wei;LI Xue-hua;LAI Yong jing;TAN Song-hua;HE Guang-yao;XIE Mao;LI Jing-yu;TANG An-zhou;YI Xiang(Department of Otorhinolaryngology,First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院耳鼻咽喉科,广西南宁530021

出　　处：《中华肿瘤防治杂志》2021年第2期100-105,共6页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的对广西五地南宁市青秀区、崇左市江州区、桂平市、宾阳县以及田东县30~59岁自然人群共248437人进行鼻咽癌血清学筛查,并对危险人群进行鼻咽活检以期促进广西鼻咽癌的早诊早治。方法以上5地各级卫生部门对所在片区30~59岁自然人群进行登记造册,ELISA法检测筛查自然人群血清中EBNA1-IgA和VCA-IgA的rA值,并将结果代入联合筛查公式计算P值,通过P值大小将人群分为鼻咽癌高危人群、EB病毒(EBV)阳性人群和EBV阴性人群。将血清学阳性+家族史者,或者头颈部体检可疑鼻咽癌者也归为高危人群。高危人群及阳性人群均行鼻内镜检查,鼻内镜下可疑鼻咽癌者进行鼻咽部活检以确诊鼻咽癌。采用SPSS17.0对数据进行统计学分析。结果筛查自然人群248437人检出EBV阳性15914人,阳性率6.41%(15914/248437),95%CI为6.31%~6.50%;鼻咽癌高危人数7487人,高危率3.01%(7487/248437),95%CI为2.95%~3.10%。检出鼻咽癌26例,鼻咽癌检出率为10.5/10万(26/248437),95%CI为6.4/10万~14.5/10万,其中阳性人群为50.00%(13/26),高危人群为50.00%(13/26);阳性人群鼻咽癌检出率为82.3/10万(13/15901),95%CI为37.3/10万~126.1/10万;高危人群鼻咽癌检出率为173.9/10万(13/7474),95%CI为79.3/10万~268.0/10万;男性鼻咽癌检出的高峰年龄为40~44岁,女性为50~54岁。结论通过ELISA法检测筛查自然人群血清中EBNA1-IgA和VCA-IgA从而对人群进行分层的筛查方案可以提高广西地区鼻咽癌的检出率。高危人群中鼻咽癌风险更高,建议增加随访频次。若筛查重点放在男性40~44岁女性50~54岁人群中,可以大幅提高鼻咽癌检出率。Objective A total of 248438 people from natural populations aged 30-59 in five regions of Guangxi,including Qingxiu district of Nanning,Jiangzhou district of Chongzuo,Guiping,Binyang County and Tiandong County,were screened for nasopharyngeal carcinoma.Biopsy was performed in the risk population to promote the early diagnosis and treatment of nasopharyngeal carcinoma in Guangxi.Methods The above-mentioned health departments at all levels in the five regions shall register and record the natural population aged 30 to 59 in their respective regions.The rA values of EBNA1-IgA and VCA-IgA were detected by Elisa,and the Pvalues were calculated by Logit to calculate Pvalue The population was divided into high-risk group,EBV(Epstein Barr Virus)positive group and EBV negative group by the value of P,in addition,those with positive serology and family history,or those with suspicious physical examination of head and neck were also classified as high-risk group.The high-risk group and the positive group were examined by nasal endoscopy.The suspicious patients were examined by biopsy in nasopharynx to confirm the diagnosis of nasopharyngeal carcinoma.Results EBV positive rate was 6.41%(15914/248437),95%CI(6.31%-6.50%)and the high-risk rate of nasopharyngeal carcinoma was 3.01%(7487/248437),95%CI(2.95%-3.10%).The detection rate of nasopharyngeal carcinoma was 10.5/100000(26/248437),95%CI(6.4/100000-14.5/100000)of which 50.00%(13/26)were from the positive population and 50.00%(13/26)were from the high-risk population.The detection rate of nasopharyngeal carcinoma was82.3/100000(13/15914)in the positive population,95%CI(37.3/100000-126.1/100000)and 173.9/100000(13/7487)in the high-risk population,95%CI(79.3/100000-268.0/100000).The peak age of nasopharyngeal carcinoma detection was 40-44 years in males and 50-54 years in females.Conclusion The screening program can improve the detection rate of nasopharyngeal carcinoma in Guangxi by stratification of the population;the risk of nasopharyngeal carcinoma is higher in high-risk po

关 键 词：血清学检测 EB病毒抗体 鼻咽癌 肿瘤防治 

分 类 号：R739.6[医药卫生—肿瘤]