鼻咽癌高发区健康成人六项EB病毒抗体检测结果的分析

Six anti-Epstein-Barr virus antibodies in healthy adults in a high risk area of nasopharyngeal carcinoma

背景与目的:鼻咽癌有明显地域倾向性,而鼻咽癌发病又与EBV密切相关。本研究通过检测来自不同地域的人群抗EBV抗体的水平和阳性率,以探讨EBV感染与鼻咽癌的地域倾向性之间的关系。方法:从鼻咽癌高发区广东省中山市的健康成人中收集303例中山原住居民的血清和92例来自非NPC高发区的外省移民的血清,用ELISA法检测血清中的EBNA1-IgA、EBNA1-IgG、VCA-p18-IgA、VCA-p18-IgG、Zta-IgA和Zta-IgG等六种抗体水平,以校正相对吸光度(ArA)值表示,逐一比较两个人群样本六项抗EBV抗体水平及阳性率的差别。结果:中山原住居民的Zta-IgA(0.84±0.03)和VCA-p18-IgA的ArA(0.96±0.05)明显高于外省移民(0.42±0.04和0.40±0.05,P<0.05)。另外,中山原住居民30～年龄段组和50～年龄段组的Zta-IgA阳性率分别是29.27%和48.28%,均明显高于外省移民同一年龄段组的3.03%和6.67%(P<0.05)。中山原住居民30～年龄段组和50～年龄段组的VCA-p18-IgA分别是28.46%和43.10%,均明显高于外省移民同一年龄段组的9.09%和13.33%(P<0.05)。结论:中山原住居民针对EBV溶解期的抗体Zta-IgA和VCA-p18-IgA的水平和阳性率偏高,反映其感染的EBV更多地处于再激活状态,这提示NPC高发区中山的原住居民罹患鼻咽癌的风险比来自非NPC高发区的外省移民更高。

Background and Objective： Nasopharyngeal carcinoma （NPC）, with a remarkable geographic distribution, is consistently associated with Epstein-Barr virus （EBV） infection, and almost all NPC patients have sustained high levels of serum antibodies against EBV. This study was to compare the levels of six anti-EBV antibodies in healthy natives of Zhongshan （a high-incidence area of NPC） with those in provisional migrants from foreign provinces （low-incidence areas of NPC）, and to illustrate the relationship between EBV infection and the geographic distribution of NPC. Methods. The serum levels of EBNAI-IgA, EBNAI-IgG, VCA-p18-IgA, VCA-p18-IgG, Zta-IgA and Zta-IgG in 303 healthy Zhongshan natives and 92 provisional migrants were tested using ELISA, and presented by values of adjusted relative absorbance （ArA）. The serum levels and positive rates of the six antibodies were compared between the two groups. Results： The mean ArA values of both Zta-IgA and VCA-p18-IgA were significantly higher in Zhongshan natives than in provisional migrants （0.84±0.03 vs. 0.42±0.04, P 〈0.05; 0.96±0.05 vs. 0.40±0.05, P〈0.05）. In addition, the positive rates of Zta-IgA and VCA-p18-IgA in subjects aged of 30-49, or of 50 and above were significantly higher in Zhongshan natives than in provisional migrants （29.27% vs. 3.03% and 48.28% vs. 6.67% for Zta-IgA, P〈0.05; 28.46% vs. 9.09% and 43.10% vs. 13.33% for VCA-p18-IgA, P〈0.05）. Conclusion： Zhongshan natives are likely to have an elevation of serum IgA antibodies against EBV lytic antigens （Zta and VCA-p18）, which represents reactivation of EBV latency infection and implies that Zhongshan natives may have higher risk to develop NPC than provisional migrants.