EB病毒壳抗原IgA抗体不同变动趋势的人群鼻咽癌发病情况比较

Comparison of incidence of nasopharyngeai carcinoma in populations with different fluctuation modes of immunoglobulin A antibody levels against Epstein-Barr virus capsid antigen

目的探讨EB病毒壳抗原IgA抗体（VCA-IgA）不同变动趋势人群的鼻咽癌发病规律。方法将586例首次检测VCA—IgA阳性且接受了至少两次复查者按抗体滴度变动趋势分为上升组114例、稳定或波动组313例、下降组159例，以9889名首次检测VCA—IgA阴性者为对照组，对其随访至2007年12月31日，根据广东省四会市肿瘤发病、死亡登记系统资料，分析各组人群的鼻咽癌发病风险、发病时间及临床特征。结果上升组、稳定或波动组、下降组人群的5年累积鼻咽癌检出率分别为3．51％（4／114）、0．64％（2／313）和0．00％（0／159）；5年累积鼻咽癌检出比例分别为4／4、2／6和0／2。与对照组相比，鼻咽癌发病风险在上升组最高（HR=10．96，95％CI：3．91—30．74），其次为稳定或波动组（HR：5．79，95％CI：2．45—13．69），下降组的发病风险为HR：3．84，95％CI：0．92—16．01。结论VCA—IgA滴度稳定、波动或上升者其鼻咽癌发病风险较高，VCA—IgA滴度上升者发病较早。

Objective To explore the incidence regularity in populations with different fluctuation modes of Epstein-Barr virus （EBV） antibody levels. Methods Based on the data of a NPC mass screening for nasopharyngeal carcinoma （NPC） in Jianggu town and Didou town of Sihui city, Guangdong province from 1992 to 1998, 586 subjects who were positive and retested for twice or above were divided into ascending group （ 114 subjects）, stable or fluctuating group （ 313 subjects）, and descending group （ 159 subjects） according to the fluctuation of immunoglobulin A antibody against EBV capsid antigen （VCA-IgA） level; 9889 subjects who were negative in the first test of VCA-IgA were set as control group. All the participants were followed-up till December 31,2007. The incidence, onset time and clinical characteristics of NPC were compared among groups. Results The 5-year cumulative detection rates of ascending, stable or fluctuating, and descending group were 3.51% （ 4/114 ）, 0. 64% （ 2/313 ） and 0. 00% （ 0/159 ）, respectively; the 5-year cumulative detection proportions were 4/4, 2/6 and 0/2, respectively. Comparing to the control group, the hazard ratio （HR） for the incidence of NPC in ascending group was highest （HR = 10. 96, 95%CI：3.91 - 30. 74）, followed by stable or fluctuating group （HR = 5.79, 95%CI：2. 45 - 13.69）, and descending group （HR= 3.84, 95%CI： 0.92 - 16.01 ） which had the lowest HR. Conclusion Individuals with stable, fluctuating or ascending VCA-IgA level showed higher risk and earlier onset of NPC was found in ascending group.