Subtype distribution and long-term titer fluctuation patterns of serum anti-Epstein-Barr virus antibodies in a non-nasopharyngeal carcinoma population from an endemic area in South China: a cohort study.
Subtype distribution and long-term titer fluctuation patterns of serum anti-Epstein-Barr virus antibodies in a non-nasopharyngeal carcinoma population from an endemic area in South China: a cohort study.
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华南非鼻咽癌流行区血清抗EB病毒抗体亚型分布及长期滴度波动规律的队列研究
DOI：
10.1186/s40880-016-0130-2
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发表时间：
2016-08-15
影响因子：
--
通讯作者：
Cao SM
中科院分区：
文献类型：
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作者：
Du JL;Chen SH;Huang QH;Xie SH;Ye YF;Gao R;Guo J;Yang MJ;Liu Q;Hong MH;Cao SM
用EB病毒（EBV）、病毒衣壳抗原（VCA-IgA）和早期抗原（EA-IgA）的血清免疫球蛋白A抗体在流行区进行鼻咽癌（NPC）筛查。然而，由于缺乏特异性，其常规使用受到质疑。本研究旨在确定不同亚型抗体的分布，并说明自然变异模式如何影响非NPC受试者筛查的特异性。使用卡方检验分析了18，286名非NPC受试者的基线VCA-IgA在性别和10岁年龄组之间的分布。在VCA-IgA水平的波动进行了评估，在1056名非NPC参与者在第一个5年期间（1987年至1992年），至少有两次复检后，使用Kaplan-Meier方法的初步筛选。VCA-IgA滴度随年龄增长而升高（P < 0.001）。使用以前的高NPC风险的血清学定义，鼻咽内窥镜检查和/或鼻咽活检将被推荐在55.5%的非NPC参与者与初始VCA-IgA阳性状态和20.6%的初始阴性状态在5年的随访。然而，血清转换是常见的; 85.2%的参与者与VCA-IgA阳性状态在基线转换为阴性，所有VCA-IgA阴性参与者在5年随访期间至少有一次变为阳性。EA-IgA状态从阳性到阴性的血清转换概率很高（100%），但是从阴性到阳性的概率很低（19.6%）。在确定NPC高危标准进行随访诊断和监测时，应考虑血清抗EBV抗体的年龄和性别特异性临界滴度值及其特异性滴度波动模式。
Serum immunoglobulin A antibodies against Epstein–Barr virus (EBV), viral capsid antigen (VCA-IgA) and early antigen (EA-IgA), are used to screen for nasopharyngeal carcinoma (NPC) in endemic areas. However, their routine use has been questioned because of a lack of specificity. This study aimed to determine the distributions of different subtypes of antibody and to illustrate how the natural variation patterns affect the specificity of screening in non-NPC participants. The distribution of baseline VCA-IgA was analyzed between sexes and across 10-year age groups in 18,286 non-NPC participants using Chi square tests. Fluctuations in the VCA-IgA level were assessed in 1056 non-NPC participants with at least two retests in the first 5-year period (1987–1992) after the initial screening using the Kaplan–Meier method. The titers of VCA-IgA increased with age (P < 0.001). Using a previous serological definition of high NPC risk, nasopharyngeal endoscopy and/or nasopharyngeal biopsy would be recommended in 55.5% of the non-NPC participants with an initial VCA-IgA-positive status and in 20.6% with an initial negative status during the 5-year follow-up. However, seroconversions were common; 85.2% of the participants with a VCA-IgA-positive status at baseline converted to negative, and all VCA-IgA-negative participants changed to positive at least once during the 5-year follow-up. The EA-IgA status had a high seroconversion probability (100%) from positive to negative; however, it had a low probability (19.6%) from negative to positive. Age- and sex-specific cutoff titer values for serum anti-EBV antibodies as well as their specific titer fluctuation patterns should be considered when defining high NPC risk criteria for follow-up diagnostics and monitoring.