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

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248 437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...

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

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 population,and the frequency of follow-up is suggested to be increased;in addition,if screening is focused on men(40-44 years old),women(50-54 years old)can significantly increase the detection rate of nasopharyngeal carcinoma.