鼻咽癌的流行病学进展  

Advancements in the epidemiology of nasopharyngeal carcinoma

作　　者：杜云 张超 冯瑞梅[3] 黄婷婷[4] 李建军 张哲[5] 叶为民[2,6] DU Yun;ZHANG Chao;FENG Ruimei;HUANG Tingting;LI Jianjun;ZHANG Zhe;YE Weimin(Department of Oncology,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm 17177,Sweden;Department of Epidemiology,School of Public Health,Shanxi Medical University,Taiyuan 030001,China;Department of Radiotherapy,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;School of Public Health,Fujian Medical University,Fuzhou 350122,China)

机构地区：[1]陆军军医大学第一附属医院肿瘤科,重庆400038 [2]瑞典卡罗琳斯卡医学院医学流行病与生物统计学系,斯德哥尔摩17177 [3]山西医科大学公共卫生学院流行病学系,太原030001 [4]广西医科大学第一附属医院放疗科,南宁530021 [5]广西医科大学第一附属医院耳鼻喉头颈外科,南宁530021 [6]福建医科大学公共卫生学院,福州350122

出　　处：《广西医科大学学报》2024年第9期1237-1246,共10页Journal of Guangxi Medical University

基　　金：国家青年科学基金资助项目(No.82204133);国家自然科学基金联合基金项目(No.U22A20322)。

摘　　要：鼻咽癌(NPC)具有显著的地理学分布特征,其病因学广受关注,包括遗传、EB病毒和环境等因素。随着研究深入,NPC病因流行病学特征逐步完善。本文以广东省和广西壮族自治区的人群病例对照研究——NPC基因、环境和EB病毒项目(NPCGEE项目)结果为重点,总结了NPC病因流行病学的最新进展。遗传因素在NPC病因中占重要作用。早期EB病毒感染可能与NPC发生有因果关系,EB病毒高危亚型可能与宿主基因相互作用,共同促进NPC进展。NPCGEE项目为NPC的流行病学提供了新的见解,尤其是环境相关病因学:中式腌鱼致病作用较前减弱,被动吸烟和室内空气污染与NPC发病风险中度正关联,职业性甲醛暴露和吸入性粉尘与NPC发病风险的关联尚不明确,口腔健康和口腔微生物群可能对NPC发病有影响。NPC的病因学特征随着更严谨的研究设计和环境变化日趋完善,但仍需要含足够数量病例的大型研究,并获取详细的暴露数据,以便更深入地了解NPC遗传、EB病毒和环境之间的相互作用。Nasopharyngeal carcinoma(NPC)exhibits a remarkable geographical distribution,and its etiology has garnered significant attention,encompassing genetic,Epstein-Barr virus(EBV),and environmental factors.With the deepening of research,the epidemiological characteristics of NPC etiology have been gradually refined.This article focuses on the findings from one case-control study,the NPC genes,environment and Epstein Barr virus(NPCGEE)project,conducted in Guangdong and Guangxi provinces,to summarize the latest advancements in the epidemiology of NPC etiology.Genetic factors play a crucial role in the etiology of NPC.Early EBV infection may have a causal relationship with the development of NPC,and the high-risk subtypes of EBV may interact with host genes to jointly promote NPC progression.The NPCGEE project provides new insights into the epidemiology of NPC,particularly in terms of environmental etiology:a diminished role of Chinese-style saltpreserved fish,modest positive associations with passive smoking and indoor air pollution,unclear associations with occupational exposure to formaldehyde and inhaled dust,and potential effects of oral health and the oral microbiome on NPC.The etiological characteristics of NPC evolve with more rigorous research designs and environmental changes.To gain a deeper understanding of the interplay between NPC genetic factors,EBV and environment,large-scale pooled studies must accumulate sufficient cases with detailed exposure data.

关 键 词：鼻咽癌 病因 遗传 EB病毒 环境 

分 类 号：R739.63[医药卫生—肿瘤]