中山市EB病毒筛查阴性人群12年追踪研究

目的探讨EB病毒在人体内的变化规律及其与鼻咽癌发病的关系.方法通过前瞻性方法对中山市1986～1987年鼻咽癌首次筛查EB病毒抗体阴性人群(38 550人)随访12年的资料以及首次筛查阳性人群(2 921人)随访7年的资料进行比较,观察上述人群EB病毒VCA/IgA的变化规律及其与鼻咽癌发病的关系.结果 EB病毒抗体VCA/IgA阴性队列每年都有一定的转阳率(22.8%),其头3年鼻咽癌发病风险仅为一般人群的11%左右,以后逐渐增加,但仍低于一般人群;与阴性队列鼻咽癌发病比较,阳性队列鼻咽癌发病风险高,相对危险度达23.22(P＜0.05).结论一定比例的VCA/IgA阴性人群可转为VCA/IgA阳性;在较长的时间内VCA/IgA阴性队列鼻咽癌发病风险较一般人群及阳性人群低;EB病毒可能是鼻咽癌发病因素,对EB病毒检测可预测鼻咽癌发生的风险,且通过抑制EB病毒活性可能达到预防鼻咽癌的目的.

12-Year Follow-up Study on Population with Negative Antibody of Epstein-Barr Virus in Zhongshan

To observe the variation of antibody of Epsetin- Barr virus (EBV) and its relationship with nasopha-ryngeal carcinoma (NPC) occurrence, and to explore the impact of this relationship on the NPC screening strategy.Method By 12 -year follow - up population with negative antibody of EBV and 7 - year follow - up of population with positive antibody of EBV after first screening during 1986 - 1987, the NPC incidences were recorded and analyzed.Results About 22.8% EBV antibody (VCA/IgA) changed from negative to positive.The risk of NPC kept in a low level in negative population comparing with general population. Standardized incidence ratio (SIR) were only about 11% in first 3 years and less than 30% in remaining period.The risk of NPC in first 4 years was significantly lower than that of remaining period.The comparison of NPC incidence rates of positive population to that of negative population showed that the relative risk of NPC was 23.22 no matter how EBV antibody level changed during the follow- up period. Conclusion The antibody level of EBV in population was a dynamic process. No matter how EBV antibody level changed, negative population ketp a low risk of NPC comparing to general population or positive population.The results suggested an etiological role of EBV to NPC and in the first 3 year after screening is a high NPC risk period for positive population and relative safe period for negative population.