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目的：通过对高癌家族成员的有效监控，探索筛查无明显症状的早期鼻咽癌病人的方法，以提高鼻咽癌早期发现、早期诊断和早期治疗。方法：选择在两代人中有 3个以上鼻咽癌患者的“高癌家系”作为本组“监控家系”，对其有血缘关系的亲属（ 1～ 3级亲属）共 121人作为本组的监控对象，对他们进行详细的鼻咽及头颈部临床检查、 EB病毒血清学抗体检测、血标本作基因定位检测。定期（约 6个月）进行追踪复查，对有可疑患癌者即作鼻咽光导纤维镜检查及鼻咽活检组织病理学检查。一旦确诊鼻咽癌，即安排治疗。结果：在接受监控的 15个家系的 121个家庭成员中，检测 EB病毒血清抗体 IgA/VCA（≥ 1∶ 10）阳性者 42人，酶联免疫吸附（ ELISA法）检测 IgG/EA（≥ 0.18）者 31人 ,阳性率分别为 34.9％及 25.6％。经首次检查及以后的 6～ 19个月追踪观察中共发现新鼻咽癌 6例，癌检出率为 4.13％（ 6/121）。 6例鼻咽癌中，Ⅰ期 5例、Ⅱ期 1例。结论：⑴鼻咽癌高癌家族成员 EB病毒相关抗体呈高阳性表达， EB病毒血清抗体检测是最佳的筛查手段；⑵鼻咽癌高癌家族人员是鼻咽癌发生的高危人群，对他们进行监控、定期追踪复查，可提高三早率，提高鼻咽癌治疗效果。
OBJECTIVE: To explore the method of screening patients with early stage nasopharyngeal carcinoma without obvious symptoms through effective monitoring of members of the high-cancer family in order to improve the early detection, early diagnosis and early treatment of nasopharyngeal carcinoma. Methods: We selected “high cancer family” who had more than 3 NPCs in two generations as the “monitoring family” and 121 relatives (1 ~ 3 relatives) with their relatives in the two generations as the group Of the monitoring object, a detailed examination of their nasopharynx and head and neck, EB virus serological antibody detection, blood samples for gene mapping. Regular (about 6 months) follow-up review of suspected patients with cancer for nasopharyngeal fiberoptic bronchoscopy and nasopharyngeal biopsy histopathological examination. Once the diagnosis of nasopharyngeal carcinoma, that is arranged for treatment. Results: Among 121 family members of 15 families under surveillance, 42 were detected positive for IgA / VCA (≥10: 10), and IgG / EA (≥0.18 ) Were 31, the positive rates were 34.9% and 25.6% respectively. Six cases of nasopharyngeal carcinoma were found after the first examination and follow-up from 6 to 19 months. The detection rate of cancer was 4.13% (6/121). Six cases of nasopharyngeal carcinoma, Ⅰ in 5 cases, Ⅱ in 1 case. Conclusion: (1) Epstein-Barr virus (EBV) -related antibodies are highly expressed in high-risk NPC family members and Epstein-Barr virus (EBV) serum antibody test is the best screening method; (2) NPC family members are high risk groups of NPC They monitor, follow-up regular review, can improve the three morning rate, improve the therapeutic effect of nasopharyngeal carcinoma.