EBNA1/IgA血清学状态及动态变化相关的鼻咽癌发病风险研究

Association between Serological Status and Fluctuation Modes of EBNA1/IgA and Risk of Nasopharyngeal Cancer

分析EB病毒核抗原1-IgA抗体(EBNA1-IgA)的不同状态及变化趋势,并探讨人群的鼻咽癌发病风险。检测中山市小榄镇2009~2010年入组的16 695位30~59岁参加鼻咽癌筛查人群血清,按首次筛查和随访中EBNA1/IgA抗体状态将筛查人群进行分组,对照组为未参加筛查的两个镇区同年龄组人群,利用中山市肿瘤登记系统、死因登记系统随访至2014年12月31日,分析各组人群的鼻咽癌发病风险。与对照组相比,基线抗体阴性人群的发病风险比为0.46(95%CI 0.25~0.86),基线抗体阳性人群的发病风险比为31.1(95%CI 21.0~46.1);复查人群中上升组、持续阳性组的发病风险比分别为82.4(95%CI 36.1~188.2),26.4(95%CI 12.3~52.5),而下降组和波动组中未见病例。EBNA1/IgA基线阳性人群在5年中有很高的发病风险,复查人群中上升组和持续阳性组也有很高的发病风险,下降组和波动组发病风险较低。

We wished to analyze the risk of nasopharyngeal cancer （NPC） in a population with different status and fluctuation modes of Epstein-Barr nuclear antigen 1 （EBNA1）/immunoglobulin A （IgA） antibody. Serology detection was conducted in 16,695 participants screened for NPC （30-59 years） enrolled from 2009 to 2010 in Xiaolan Town, Zhonghan City, China. Participants were divided into groups according to EBNA1/IgA antibody status at baseline and follow-up. Subjects who did not undergo screening in two neighboring towns of Xiaolan were designated the control group. All study participants were followed up to 31 December 2014 with linkage to a cancer registry. A population registry in Zhongshan City was used to analyze NPC risk in different groups. Compared with the control group, the relative risk （RR） of NPC in participants who were sero-negative and sero-positive at baseline was 0.46 （95% CI 0.25-0.86）and 31. 1 （21.0-46.1）, respectively. The RR of NPC in participants of the ascending group and persist-positive group who underwent retesting was 82.4 （95% CI 36.1-188.2） and 26.4 （12.3-52.5）, respectively. No NPC cases were observed in the descending group or fluctuating group. Individuals in the ascending group, persist-positive group and those who were EBNA1/IgA antibody-positive at baseline had a higher risk of NPC. A lower risk of NPC in the descending group and fluctuating group was observed compared with that in the control group.