鼻咽癌患者发病前后EB病毒VCA/IgA和EA/IgA滴度动态分析  

A dynamic study on titer of EB virus VCA/IgA and EA/IgA in nasopharygeal carcinoma patients

作　　者：季明芳 郭媛卿 梁锦胜 郑受昂 程伟民 余炳辉 欧星泰 王得坤 

机构地区：[1]广东省中山市肿瘤研究所,528403

出　　处：《中华肿瘤杂志》2003年第3期243-245,共3页Chinese Journal of Oncology

基　　金：国家重点科技基金资助项目 ( 75 61 0 2 13 )

摘　　要：目的　观察鼻咽癌患者发病前后EB病毒VCA IgA、EA IgA滴度的变化规律 ,及其在鼻咽癌筛查中的作用。方法　收集中山市首次鼻咽癌筛查后 12年VCA IgA阳性人群中 5 4例新发鼻咽癌患者发病前后的血清学资料 ,用免疫酶法检测EB病毒抗体VCA IgA和EA IgA。结果　确诊前 1～7年VCA IgA、EA IgA总体呈上升趋势。发病前 7～ 4年VCA IgA平均滴度在 1∶2 1.0 4上下波动 ,确诊前第 3年起VCA IgA急剧上升 ,确诊时几何平均滴度接近 1∶80。EA IgA升高较为缓慢 ,确诊时几何平均滴度为 1∶6 .4 9。放疗后两种滴度均呈快速下降趋势 ,第 4年起接近阳性人群的平均滴度。结论多数鼻咽癌患者在确诊前 3年VCA IgA滴度持续增高 ,但EA IgA滴度增高缓慢 ;VCA IgA可以检出早期鼻咽癌 ,但EA IgA作用不大 ;鼻咽癌发展临床前期平均时间为 3年。Objective To analyze the change of EB virus VCA/IgA and EA/IgA titer during the development of nasopharyngeal carcinoma (NPC), and the role in screening for NPC. Methods VCA/IgA and EA/IgA were monitored in a period of 12 years by immunoenzymatic titration from the sera of 54 NPC patients after primary serological screening. Results VCA/IgA and EA/IgA titer had shown gradual increment 1 7 years before NPC was pathologically diagnosed. The mean titer of VCA/IgA was 1∶21.04, 7 4 years before diagnosis. VCA/IgA titer ascended quickly within 3 years before diagnosis .The geometric mean titer (GMT) of VCA/IgA and EA/IgA were 1∶76.86 and 1∶6.49 when NPC was diagnosed, which descended quickly after radiotherapy and, in 4 years, approached the average titer of VCA/IgA positive population. Conclusion VCA/IgA titer rises uninterruptedly 3 years before NPC is diagnosed pathologically in most patients but their EA/IgA titer rises slowly. The detection of VCA/IgA titer can be used to find early NPC, whereas EA/IgA can not. The pre clinical phase of NPC is 3 years according to this dynamic study. [

关 键 词：鼻咽癌 EB病毒 免疫球蛋白 免疫酶标法 血清学筛查 

分 类 号：R739.63[医药卫生—肿瘤]