Two Epstein-Barr Virus-Related Serologic Antibody Tests in Nasopharyngeal Carcinoma Screening: Results From the Initial Phase of a Cluster Randomized Controlled Trial in Southern China
Two Epstein-Barr Virus-Related Serologic Antibody Tests in Nasopharyngeal Carcinoma Screening: Results From the Initial Phase of a Cluster Randomized Controlled Trial in Southern China
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DOI：
10.1093/aje/kws404
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发表时间：
2013-02-01
影响因子：
5
通讯作者：
Cao, Su-Mei
中科院分区：
文献类型：
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作者：
Liu, Zhiwei;Ji, Ming-Fang;Cao, Su-Mei
在中国南方进行了一项鼻咽癌（NPC）大规模筛查试验，采用酶联免疫吸附测定结合抗 Epstein-Barr 病毒衣壳抗原和核抗原 1 的免疫球蛋白 A 抗体，以及鼻咽间接镜像检查和/或淋巴触诊 (IMLP)。 2008 年 5 月至 2010 年 5 月，通过整群抽样随机抽取居住在四会和中山 2 个城市的 3059 岁广东人被邀请参加此次筛查。如果参与者的血清学检测达到我们预定的高风险水平或体检结果表明可能患有癌症（即 IMLP 阳性），则对参与者进行纤维内窥镜检查和/或病理活检。第一轮共有 28,688 人自愿接受筛查。随访第一年，鼻咽癌总体检出率为 0.14 (41/28,688)，早期诊断率为 68.3 (28/41)。高危组41例中检出38例（92.7），IMLP阳性组41例中检出7例（17.1）。通过酶联免疫吸附测定进行的 2 EB 病毒血清学检测可能是流行地区鼻咽癌筛查的可行替代方案。需要进一步随访以检查筛查是否对降低这些地区鼻咽癌死亡率有影响。
A nasopharyngeal carcinoma (NPC) mass screening trial using a combination of immunoglobulin A antibodies to Epstein-Barr virus capsid antigen and nuclear antigen-1 by enzyme-linked immunosorbent assay in addition to indirect mirror examination in the nasopharynx and/or lymphatic palpation (IMLP) was conducted in southern China. Cantonese aged 3059 years residing in 2 cities randomly selected by cluster sampling, Sihui and Zhongshan, were invited to participate in this screening from May 2008 through May 2010. Participants were offered fiberoptic endoscopy examination and/or pathologic biopsy if their serologic tests reached our predefined level of high risk or if results from the physical examination indicated possible cancer (i.e., were IMLP positive). A total of 28,688 individuals were voluntarily screened in the initial round. The overall NPC detection rate was 0.14 (41/28,688) with an early diagnosis rate of 68.3 (28/41) during the first year of follow-up. Thirty-eight of 41 cases (92.7) were detected among the high-risk group, and 7 of 41 cases (17.1) were detected among the IMLP-positive group. The 2 Epstein-Barr virus serologic tests by enzyme-linked immunosorbent assay could be a feasible alternative for NPC screening in endemic areas. Further follow-up is needed to examine whether screening has an effect on decreasing mortality from NPC in these areas.