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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 observe the change rule of Epstein-Barr virus (VCA) IgA, EA IgA titers before and after the onset of nasopharyngeal carcinoma (NPC) and its role in the screening of nasopharyngeal carcinoma. Methods The serological data of 54 newly diagnosed nasopharyngeal carcinoma patients in VCA IgA positive population collected from Zhongshan for the first time after 12 years of nasopharyngeal carcinoma screening were collected. The antibody against Epstein - Barr virus (VCA) IgA and EA IgA were detected by immunoenzymatic method. Results VCA IgA and EA IgA generally showed an upward trend in the first 1-7 years before diagnosis. VCA IgA titers fluctuated around 1: 2 1.04 7-4 years before onset. VCA IgA rose sharply in the third year before diagnosis, and the geometric mean titer at diagnosis was close to 1:80. EA IgA increased more slowly, with a geometric mean titer of 1: 6. The two titers showed a rapid decline after radiotherapy, and the average titer approached to positive in the fourth year. Conclusions The titer of VCA and IgA in the majority of patients with nasopharyngeal carcinoma continues to increase, but the titer of EA IgA increases slowly. VCA and IgA can detect early nasopharyngeal carcinoma with little effect of EA IgA. The mean of preclinical development of nasopharyngeal carcinoma The time is 3 years.