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目的 探讨EB病毒在人体内的变化规律及其与鼻咽癌发病的关系。方法 通过前瞻性方法对中山市1986～1987年鼻咽癌首次筛查EB病毒抗体阴性人群(38 550人)随访12年的资料以及首次筛查阳性人群(2921人)随访7年的资料进行比较,观察上述人群EB病毒VCA/IgA的变化规律及其与鼻咽癌发病的关系。结果 EB病毒抗体VCA/IgA阴性队列每年都有一定的转阳率(22.8％),其头3年鼻咽癌发病风险仅为一般人群的11％左右,以后逐渐增加,但仍低于一般人群;与阴性队列鼻咽癌发病比较,阳性队列鼻咽癌发病风险高,相对危险度达23.22(P<0.05)。结论 一定比例的VCA/IgA阴性人群可转为VCA/IgA阳性;在较长的时间内VCA/IgA阴性队列鼻咽癌发病风险较一般人群及阳性人群低;EB病毒可能是鼻咽癌发病因素,对EB病毒检测可预测鼻咽癌发生的风险,且通过抑制EB病毒活性可能达到预防鼻咽癌的目的。
Objective To investigate the variation of Epstein-Barr virus (EBV) in human and its relationship with the pathogenesis of nasopharyngeal carcinoma. Methods A prospective study was conducted to compare the first 12 years of follow-up of EBV antibody negative population (38 550) with the first screening of positive population (2921 persons) in Zhongshan from 1986 to 1987 for comparison. , Observed the above population EBV VCA / IgA changes and its relationship with the incidence of nasopharyngeal carcinoma. Results The negative rate of VCA / IgA negative in EBV antibody every year was 22.8%. The incidence of nasopharyngeal carcinoma in the first 3 years was only 11% of the general population, then increased gradually but still lower than that of the general population Compared with the incidence of negative cohort nasopharyngeal carcinoma, the positive cohort had a higher risk of nasopharyngeal carcinoma with a relative risk of 23.22 (P <0.05). Conclusions A certain proportion of VCA / IgA negative population can be converted to VCA / IgA positive. In a longer period of time, the risk of VCA / IgA negative co-occurrence is lower than that of general population and positive population. EB virus may be the risk factor of nasopharyngeal carcinoma , The detection of Epstein-Barr virus can predict the risk of nasopharyngeal carcinoma, and by inhibiting the activity of EB virus may achieve the purpose of preventing nasopharyngeal carcinoma.