摘要
目的：观察鼻咽癌（NPC）患者发病前后EBVVCA—IgA和EA—IgA滴度的变化规律及其在NPC筛查中的作用。方法：收集广西桂东南地区首次NPC筛查后12年VCA—IgA阳性人群中55例新发NPC患者发场前后的血清学资料，用免疫酶法检测EBVVCA—IgA和EA—IgA抗体。结果：确诊前1～7年VCA—IgA和EA—IgA总体呈上升趋势。发病前7～4年VCA—IgA平均滴度在1：20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1：6．49。放疗后两种滴度均呈现快速下降趋势，第4年起接近阳性人群的平均滴度。结论：多数NPC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可检出早期NPC，但EA—IgA作用不大，NPC发展临床前期平均时间为3年。
Objective To analyze the change of EB Virus （EBV） VCA- IgA and EA- IgA titer during the development of nasopharyngeal carcinoma （NPC） and the role in screening for NPC. Methods VCA- IgA and EA- IgA were monitored in a period of 12 years by immunoenzymatie titration from the sera of 55 NPC patients after primary serological screening. Results VCA - IgA and EA- IgA tites had shown gradual increment 1-7 years before NPC was pathologically diagnosed. The mean titer of VCA- IgA was 1：21.04. 7-4 years before diagnosis. VCA- IgA tiuer ascended qnickly within 3 years before diagnosis. The geometric mean titer GMT of VCA - IgA and EA- IgA were 1 ： 76.86 and 1 ： 6.49 When NPC was diagnosed. Which descended quickly ofter radiotherapy and in 4 years, approached the average titer of VCA- IgA positive population. Conclusion VCA- IgA titer rises uninterruptedly 3 years before NPC is diagnosed pathologically in most patients but their EA- IgA titer rises slowly. The detection of VCA- IgA titer can be used to find early NPC, whereas EA- IgA can not. The preclinical phase of NPC is 3 years aceording to this dynamic study.
