韶关市健康人群EB病毒IgA/VCA抗体调查

作者1989—1990年对市区工人、干部2755人,以免疫酶法进行了EB病毒IgA/VCA、IgA/EA抗体检测,共检出IgA/VCA抗体阳性79人,阳性率2.86%(79/2755);阳性结果与性别、年龄关系不大;IgA/EA抗体全部阴性,均未追踪观察,故转归情况未明。     

鼻咽癌高发家族成员EB病毒IgA／VCA抗体反应状况对比分析

为了解鼻咽癌(nasopharyngeal carcinorna,NPC)高发家族成员EB病毒IgA/VCA抗体反应状况及遗传因素与EB病毒感染在NPC发生过程中的作用,笔者从10万余名健康体检者中筛查出具有NPC高发家族史者38人,对其本人及家系成员共计163人的EB病毒感染状况及NPC发病状况、家族史等进行了调查随访,并将其结果与来自同一地区的自然人群351人的筛查结果进行对比分析,结果如下.     

苯系毒物作用下人体内抗EB病毒抗体水平的变化

目的 研究苯系毒物作用下体内抗EB2病毒抗体水平的变化。方法 选择苯系毒物接触工人558人和无接触者372人作为对照,用ELISA方法EB病毒抗体。结果（1）苯系毒物接触者体内EB病毒IgA/VCA抗体阳性检出率（26．0％）与非接触阳性检出率（11.3％）差异有显著性（P＜0．01）;（2）苯与甲苯、二甲苯均能引起体内IgA/VCA上升,其抗体滴度≥1：100的阳性检出率三者差异均无显著性（P＞0．05）;（3）0．2－0．5年的苯系毒物接触工龄即可使体内的IgA/VCA明显上升,但其抗体水平并不随着接触工龄的增加而呈上升趋势。结论 职业性接触苯系毒物可能使潜伏于人体的EB病毒受到激活。     

EB病毒VCA-IgA抗体水平对鼻咽癌放射治疗远期预后的评估

许多的研究表明EB病毒与鼻咽癌关系密切[1] 。对其的研究多见于EB病毒在鼻咽癌的发生发展中的作用及早期诊断方面[1,2 ] 。EB病毒壳抗原的免疫球蛋白A(VCA -IgA)抗体在鼻咽癌的诊断中较为特异 ,临床上关于应用检测VCA -IgA滴度评价鼻咽癌患者放射治疗 (放疗 )远期预后的报道较少。本文观察 1 2 9例鼻咽癌患者放疗前VCA -IgA不同滴度对放射治疗远期预后的影响 ,旨在探讨VCA -IgA抗体滴度和预后的内在联系。1　资料与方法1·1　一般资料　选择 1 2 9例首诊的鼻咽癌患者 ,经病理切片证实为低分化鳞癌 ,Karnofsky评分≥ 70分 ,年龄1…     

广东中山小榄地区大样本人群鼻咽癌筛查两种抗体水平分析

目的：通过对鼻咽癌高发区大样本人群鼻咽癌筛查两种抗体水平分析，为鼻咽癌高发区的防治策略提供科学依据。方法：应用ELISA法检测EBNA1-IgA和EBVCA-IgA抗体，对两种EB病毒抗在性别、年龄的阳性率和可疑阳性率的分布特征进行研究。结果：筛查人群EBNA1-IgA抗体阳性率和可疑阳性率分别为9.27%（778/8395）、12.54%（1053/8395），EBVCA-IgA抗体阳性率和可疑阳性率分别为11.79%（990/8395）、13.60%（1142/8395）。男性EBNA1-IgA抗体阳性率为10.53%，高于女性的8.01%，差异有统计学意义（P〈0.05）；男、女性EBVCA-IgA抗体阳性率分别为11.77%和11.82%，两组比较差异无统计学意义（P〉0.05）。结论：EBNA1-IgA抗体（45--60岁年龄段）分布男性高于女性。VCA-IgA抗体阳性率无显著差异，筛查人群的EBNA1-IgA和VCA/IgA抗体阳性率和可疑阳性率随着年龄增长逐渐上升。提示须加强对此年龄段人群的EB病毒感染的定期筛查，可提高鼻咽癌的早诊率。     

EB病毒不同抗原IgA抗体检测在鼻咽癌诊断中的作用

目的探讨EB病毒壳抗原（VCA）、早期抗原（EA）和核抗原潜伏蛋白（EBNA1）免疫球蛋白A抗体（IgA）的检测对鼻咽癌血清学诊断的意义。方法应用免疫酶法（IE）和酶联吸附试验（ELISA）检测326例鼻咽癌患者、1290例非鼻咽癌门诊患者、职工体检767例血清中EB病毒VCA／IgA、EA／IgA、NA1／IgA抗体。结果鼻咽癌患者VCA／IgA、EA／IgA、EBNA1／IgA抗体阳性率分别为97．9％、8t．9％、和87．7％;非鼻咽癌患者组为18．0％、0．2％、和15．3％;对照组为5．1％、0、13．8％。鼻咽癌组的三种IgA抗体阳性率均分别高于非鼻咽癌组和对照组（P〈0．001）,非鼻咽癌组的VCA／IgA抗体阳性率亦高于对照组（P〈0．001）。检测VCA／IgA的灵敏度和特异度为97．9％和94．9％;EA／IgA为引．9％和100％;EBNAI／IgA为87．7％和86．2％。结论VCA灵敏度和特异度都在较高的水平;EA灵敏度低特异度高;EBNA1灵敏度和特异度不及VCA,提示免疫酶法检测VCA／IgA抗体仍然是鼻咽癌血清学诊断中理想的方法,ELISA法EBNAI／IgA检测灵敏度和特异度比前者低有待进一步改进。     

EB病毒VCA-IgA在鼻咽癌筛查中的临床意义

目的探讨血清EB病毒衣壳抗原（EB-VCA IgA）在鼻咽癌筛查的临床意义。方法以2009年7月-2011年6月期间在本院进行EB-VCA IgA筛查的3 820例居民为研究对象,用酶联免疫吸附法测定血清EB-VCA IgA;对结果异常者取鼻咽部黏膜脱落细胞或活体组织检查,分析EB-VCA IgA在鼻咽癌筛查中的意义。结果在3 820例居民中,EB病毒抗体阳性48例（1.26%）,确诊为鼻咽癌2例。结论在鼻咽癌的高发地区,EB-VCA IgA可作为一项常规防癌检查项目,以有利于鼻咽癌的早期发现、早期诊断、早期治疗。     

鼻咽癌非病毒危险因素的主成分改进Logistic回归分析

[目的]应用主成分改进的Logistic回归模型评估非病毒危险因素在中国南方鼻咽癌发病中的作用. [方法]采用病例-对照研究方法,选择来自梧州市和苍梧县及其周边两广高发市县的经病理学确诊的鼻咽癌病人1010例,以及正常人对照1009例.病例与对照的EB病毒IgA/VCA检测均为阳性.对有关暴露因素进行单因素及多因素逐步非条件Logistic回归分析,以主成分改进的Logistic回归分析解决共线性问题. [结果]应用主成分分析改进后的Logistic回归模型拟合数据,不仅各回归系数的标准误均有减小,而且有更多的因素被选入模型.研究结果显示有鼻咽癌家族史及鼻咽癌一级亲属的EB病毒IgA/VCA阳性个体患鼻咽癌的风险会升高3.04倍、3.71倍.食用成鱼及熏肉、经常接触柴火及有机溶剂、较早年龄开始吸烟会显著增加患鼻咽癌的风险,其OR值分别为1.88、1.97、3.99、3.01、2.04. [结论]在调整EB病毒感染状态因素后,主成分改进的Logistic回归分析结果证实在南方高发区鼻咽癌家族史、食用成鱼及熏肉、接触柴火及有机溶剂、吸烟仍然是鼻咽癌的非病毒危险因素.     

EB病毒与鼻咽癌关系的前瞻性研究

采用前瞻性方法对ＥＢ病毒与鼻咽癌的关系进行了调查。根据随访１９８７年广州市、中山市和四会市近１０万居民ＥＢ病毒抗体（ＶＣＡ／ＩｇＡ）普查中所有阳性人群和配对选择阴性对照资料，到１９９４年底，共发现鼻咽癌９４例，其中阳性队列９１例，阴性队列３例，累积发病率分别为１３１３‰和１２６‰，调整性别年龄后相对危险度为１０１４。９５％可信区间为３４８～４７６０。结果表明，ＥＢ病毒与鼻咽癌有密切的关联，除具有筛检的意义外，还提示长期的高鼻咽癌风险。     

血清库在鼻咽癌研究中的应用

一、一般资料：（１）血清标本来源：①广东鼻咽癌高发区９８１８０名３０～５９岁健康人从１９８６～１９９８年进入队列时血清。②队列人群中ＥＢＶＶＣＡ／ＩｇＡ（ＥＢ病毒壳抗原抗体ＩｇＡ）阳性（滴度≥１∶５）人群和阴性（滴度＜１∶５）对照者进入队列及其后每次监测血清。③队列人群中检出鼻咽癌患者发病前、发病、治疗后血清。④队列人群中高癌家族（两代人中有２例以上鼻咽癌）患者及健康成员血清。（２）血液采集、血清分离与保存：①队列人群按筛查方案分层监测，每次监测除头颈物理检查外，抽血３ｍｌ。②全血在现场即离心分…     

鼻咽癌疾病自然史的随机模型研究

本文应用马尔科夫随机模型估计从正常到ＥＢ病毒抗体阳性，再到鼻咽癌的转移概率。结果显示ＥＢ病毒抗体水平的波动较大，而多次随访检查能提高敏感度。模型参数检验也揭示ＥＢ病毒抗体的变化特征与鼻咽癌发生相关。鼻咽癌临床前期最大逗留时间为４．３６年，应用ＥＢ病毒抗体检测的敏感度达９９．９８％。这些结果为鼻咽癌筛查的效果评价提供了依据。     

The distinctive profile of risk factors of nasopharyngeal carcinoma in comparison with other head and neck cancer types

Background

Nasopharyngeal carcinoma (NPC) and other head and neck cancer (HNCA) types show a great epidemiological variation in different regions of the world. NPC has multifactorial etiology and many interacting risk factors are involved in NPC development mainly Epstein Barr virus (EBV). There is a need to scrutinize the complicated network of risk factors affecting NPC and how far they are different from that of other HNCA types.

Methods

122 HNCA patients and 100 control subjects were studied in the region of the Middle East. Three types of HNCA were involved in our study, NPC, carcinoma of larynx (CL), and hypopharyngeal carcinoma (HPC). The risk factors studied were the level of EBV serum IgG and IgA antibodies measured by ELISA, age, sex, smoking, alcohol intake, histology, and family history of the disease.

Results

EBV serum level of IgG and IgA antibodies was higher in NPC than CL, HPC, and control groups (p < 0.01). NPC was associated with lymphoepithelioma (LE) tumors, males, regular alcohol intake, and regular smoking while CL and HPC were not (p < 0.05). CL and HPC were associated with SCC tumors (p < 0.05). Furthermore, NPC, unlike CL and HPC groups, was not affected by the positive family history of HNCA (p > 0.05). The serum levels of EBV IgG and IgA antibodies were higher in LE tumors, regular smokers, younger patients, and negative family history groups of NPC patients than SCC tumors, non-regular smokers, older patients and positive family history groups respectively (p < 0.05) while this was not found in the regular alcoholics (p > 0.05).

Conclusion

It was concluded that risk factors of NPC deviate much from that of other HNCA. EBV, smoking, alcohol intake, LE tumors, male patient, and age > 54 years were hot risk factors of NPC while SCC and positive family history of the disease were not. Earlier incidence, smoking, LE tumors, and negative family history of the disease in NPC patients were associated much clearly with EBV. It is proposed that determining the correct risk factors of NPC is vital in assigning the correct risk groups of NPC which helps the early detection and screening of NPC.     

2007年吉林省艾滋病病毒抗体检测结果分析

目的分析2007年高危人群艾滋病病毒（HIV）抗体检测数据，对现行的检测试剂进行初步评估。方法按照《全国艾滋病检测技术规范》（2004年版）规定的检测方法，对吉林省各艾滋病筛查中心实验室送检的HIV抗体筛查阳性样本进行HIV抗体确认和分析。结果2007年222例HIV抗体筛查阳性样本进行确认试验后，有179例（80．6％）为HIV-1抗体阳性，31例（14．0％）HIV抗体不确定，12例（5．4％）HIV抗体阴性。12例阴性样本中出现假阳性结果ELISA试剂11例，快速试剂1例。结论HIV抗体筛查试剂存在一定的假阳性，导致确认试验抗体不确定和阴性结果数量的增加。对出现抗体不确定结果的样本应加强随访检测，同时考虑使用其它辅助诊断方法。     

Familial tendency and risk of nasopharyngeal carcinoma in taiwan: effects of covariates on risk

In the present study, the authors compared the long-term risk of nasopharyngeal carcinoma (NPC) of male participants in an NPC multiplex family cohort with that of controls in a community cohort in Taiwan after adjustment for anti-Epstein-Barr virus (EBV) seromarkers and cigarette smoking. A total of 43 incident NPC cases were identified from the 1,019 males in the NPC multiplex family cohort and the 9,622 males in the community cohort, for a total of 8,061 person-years and 185,587 person-years, respectively. The adjusted hazard ratio was 6.8 (95% confidence interval (CI): 2.3, 20.1) for the multiplex family cohort compared with the community cohort. In the evaluation of anti-EBV viral capsid antigen immunoglobulin A and anti-EBV deoxyribonuclease, the adjusted hazard ratios were 2.8 (95% CI: 1.3, 6.0) and 15.1 (95% CI: 4.2, 54.1) for those positive for 1 EBV seromarker and positive for both seromarkers, respectively, compared with those negative for both EBV seromarkers. The adjusted hazard ratio was 31.0 (95% CI: 9.7, 98.7) for participants who reported a family history of NPC and who were anti-EBV-seropositive compared with individuals without such a history who were anti-EBV-seronegative. The findings suggest that both family history of NPC and anti-EBV seropositivity are important determinants of subsequent NPC risk and that the effect of family history on NPC risk cannot be fully explained by mediation through EBV serologic responses.     

HIV抗体筛查阳性标本的确证结果分析

目的通过对HIV抗体筛查(ELISA)阳性标本进行确证试验(WB),分析两者之间的关系;了解不确定结果的抗体进展情况。方法按照《全国艾滋病检测技术规范》(2009版)的方法和要求,对284例HIV抗体筛查(ELISA)阳性标本采用WB进行确证,对确证结果不确定者进行随访复查。结果 284例(ELISA)阳性标本中,228例确证(WB)HIV阳性、41例不确定、15例阴性。41例不确定经后续复查25例进展为确证阳性、其中20例在四周内进展为阳性。结论 s/co值>6.0以上的阳性标本,确证阳性率明显增高;不确定结果的复查可根据受检者的高危行为提前进行。     

用体外致敏的鼻咽癌患者B细胞构建全人源噬菌体单链抗体库

目的构建全人源抗鼻咽癌噬菌体单链抗体库，为筛选鼻咽癌相关抗原的抗体奠定基础。方法采用体外致敏与EB病毒（EBV）转化鼻咽癌患者的外周血单个核细胞（PBMC），提取总RNA，用RT—PCR技术扩增人抗体重链可变区VH基因和轻链可变区VL基因，用编码（Gly4Ser）3的互补序列连接成单链抗体ScFv基因（VH-linker—VL），并克隆到噬菌粒载体FUSE5，转化大肠杆菌MC1061，构建噬菌体呈现型ScFv库。结果成功地构建了全人源抗鼻咽癌噬菌体单链抗体库，库容量为6．5×10^7，约100％的噬菌体基因中有ScFv基因的插入。结论联合应用体外致敏和EBV转化及噬菌体呈现技术构建全人源抗鼻咽癌噬菌体单链抗体库是可行的，这为进一步筛选鼻咽癌相关抗原的抗体奠定了基础。     

避孕节育服务与生殖道感染防治相结合的探索

目的:利用避孕节育随访服务探讨育龄妇女生殖道感染(RTI)的影响因素。方法:对2002年9～11月接受计划生育随访服务的13066名育龄妇女进行妇科检查和RTI的病原体实验室筛查。结果:RTI总检出率为52.72％,其中患1种病症占39.95％,2种占11.68％,3种及以上占1.09％。在宫内节育器(IUD)使用者62.63％有RTI临床症状。未有症状者中,分泌物异常或下腹痛出现率为11.41％。上述病症的发生率苏北地区明显高于苏南地区。RTI影响因素分别为初婚年龄、职业、文化程度、孕次、活产数、人工流产数和避孕方法。结论:江苏省RTI的流行有明显的地区差异,不同地区的危险因素和保护因素各不相同。提示避孕节育随访服务对重点人群进行RTI监测与防治即可达到较好的防治效果。     

Incidence and risk factors for hepatitis C infection in a cohort of women in rural Egypt

A prospective cohort study of the incidence and risk factors for hepatitis C virus (HCV) infection was performed in 2171 pregnant women in three rural Egyptian villages who were HCV antibody (anti-HCV) and RNA (HCV-RNA) negative at baseline. During an average of 2.2 years follow up, 25 incident cases were observed, giving an estimated HCV incidence of 5.2/1000 person-years (PY). The infection rate correlated with community anti-HCV prevalence in pregnant women, while the perinatal incidence rate of 11.2/1000 PY was almost five times that of the non-perinatal rate (2.3/1000 PY). The data suggested iatrogenic perinatal risk factors were associated with infection in one village, while health education reduced infections in another. Among the 25 incident cases, eight were HCV-RNA negative when they were first found to be anti-HCV positive and one-third of the 15 viraemic cases with follow-up data available cleared their HCV-RNA after an average of 1.3 years. None of the 25 incident cases were jaundiced or had symptoms of hepatitis but elevated serum alanine aminotransferase levels confirmed hepatitis in nine. Our data suggest that asymptomatic HCV infections frequently occurred during the perinatal period but often cleared and that educating medical personnel on safe practices possibly reduced HCV transmission.     

How does tuberculosis relate to HIV positive and HIV negative drug users?

OBJECTIVES: (1) To compare the incidence of active tuberculosis in HIV positive and HIV negative drug users. (2) To describe the main characteristics of the tuberculosis cases. DESIGN: A prospective study was performed from 1986 to 1996 as part of an ongoing cohort study of HIV infection in Amsterdam drug users. METHODS: Data from the cohort study, including HIV serostatus and CD4-cell numbers, were completed with data from the tuberculosis registration of the tuberculosis department of the Amsterdam Municipal Health Service. Analyses were carried out with person time and survival methods. RESULTS: Of 872 participants, 24 persons developed culture confirmed tuberculosis during a total follow up period of 4000 person years (0.60 per 100 py, 95% CI: 0.40, 0.90). Nineteen cases were HIV positive (1.54 per 100 py, 95% CI: 0.86, 2.11) and five HIV negative (0.18 per 100 py, 95% CI: 0.08, 0.43). Multivariately HIV infection (relative risk: 12.9; 95% CI: 3.4, 48.8) and age above 33 years (RR: 6.8; 95% CI: 1.3, 35.0, as compared with age below 27) increased the risk for tuberculosis substantially. Additional findings were: (1) 13 of 22 pulmonary tuberculosis cases (59%) were detected by half yearly radiographic screening of the chest; (2) tuberculosis occurred relatively early in the course of HIV infection at a mean CD4 cell number of 390/microliter; (3) an estimated two thirds of the incidence of tuberculosis observed among HIV positive cases was caused by reactivation; (4) all but one patient completed the tuberculosis treatment. CONCLUSION: HIV infection increases the risk for active tuberculosis in Amsterdam drug users 13-fold. The incidence of tuberculosis in HIV negative drug users is still six times higher than in the overall Amsterdam population. In the absence of contact tracing and screening with tuberculin skin tests, periodic chest radiographic screening contributes substantially to early casefinding of active tuberculosis in Amsterdam drug users.