无症状鼻咽癌临床分析和长期随访研究

目的：观察无症状鼻咽癌Epstein-Barr(EB)病毒血清学、鼻咽纤维镜表现和预后。方法：1986年12月采用免疫酶标法检测血清EB病毒壳抗原抗体（viral capsid antigen‘s IgA,VCA-IgA)、早期抗原抗体（early antigen‘s IgA,EA-IgA)，行间接鼻咽镜和鼻咽纤维镜检查及多部位活体组织检查。确诊鼻咽癌后行根治性放射治疗，随访至1999年底。结果：早期无症状鼻咽癌患者确诊时血清EB病毒VCA－IgA、EA－IgA抗体水平分别为1：100．79、1：10．76，与有症状患者比较差异无显著性意义（P＞0．05）。有、无症状患者生存率比较差异有显著性意义（χ^2=6.73,P=0.009)。有、无症状患者确诊时血清VCA－IgA、EA－IgA滴度水平与患者预后均无关（P＞0．05），与是否出现颈淋巴结转移无关（P＞0．05）。结论：定期检测EB病毒抗体、鼻咽纤维镜检查及多部位活体组织检查，有助于检出早期鼻咽癌，尤其是无症状鼻咽癌。

Clinical analysis and long-term follow up study of asymptomatic nasopharyngeal carcinoma patients]

OBJECTIVE: To observe the character of Epstein-Barr(EB) virus serology, fibroscopy appearance and prognosis of asymptomatic nasopharyngeal carcinoma(NPC). METHODS: Viral capsid antigen's IgA (VCA/IgA) of EB virus and early antigen's IgA(EA/IgA) of EB virus were detected by immunoenzymatic method. The clinical examination was carried out, including indirect mirror examination and fibroscopy of the nasopharynx and multiple biopsies. All patients of NPC were followed up to the end of 1999. RESULTS: 1. The geometric mean titer of VCA/IgA and EA/IgA are 1:100.79 and 1:10.76 respectively when asymptomatic NPC was diagnosed. There were no significant difference between VCA/IgA and EA/IgA antibody titres of asymptomatic patients and symptomatic cases (P > 0.05). The survival rates in these asymptomatic cases were higher than symptomatic patients (P < 0.05). 2. There was no correlation with the VCA/IgA or EA/IgA titer and the prognosis (P > 0.05) and the cervical lymph node metastasis (P > 0.05) when NPC was diagnosed. CONCLUSION: This is helpful to detect asymptomatic NPCs by EB serological screening periodically and nasopharyngeal fibroscopy and multiple biopsies.