Sustained elevation of Epstein-Barr virus antibody levels preceding clinical onset of nasopharyngeal carcinoma.
Sustained elevation of Epstein-Barr virus antibody levels preceding clinical onset of nasopharyngeal carcinoma.
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DOI：
10.1038/sj.bjc.6603609
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发表时间：
2007-02-26
影响因子：
8.8
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我们对39例鼻咽癌患者进行了EB病毒伊加抗体水平的监测，并对68例鼻咽癌患者进行了临床前血清学检测。我们的研究结果确定了诊断前的血清学窗口时，抗体水平的提高和持续。该窗口期可持续长达10年，平均持续时间估计为37±28个月。在这107例NPC病例中，有97例出现了这样的窗口期。没有的病例可能反映了个体对EBV的抗体应答。入组时的血清学筛查确定了那些已经进入窗口期并且比入组后进入窗口期的病例（中位数=90个月）更早（中位数=28个月）出现临床表现的病例。前者占筛查后2年内确诊的21例中的19例。在此期间，血清阳性受试者中鼻咽癌的风险水平也最高。此后，预测率和风险水平均有所下降;后来发现的病例中，筛查后进入血清学窗口期的个体比例越来越高。我们的研究结果确立了EBV抗体作为NPC的早期标志物，并表明当他们进入这个窗口时，反复筛查以监测病例具有相当大的预测价值，对癌症治疗具有实际意义。
We have monitored Epstein–Barr virus (EBV) IgA antibody levels of 39 nasopharyngeal carcinoma (NPC) cases for up to 15 years before clinical onset of NPC, and assessed preclinical serologic status of another 68 cases. Our results identify a serologic window preceding diagnosis when antibody levels are raised and sustained. This window can persist for as long as 10 years, with a mean duration estimated to as 37±28 months. Ninety-seven of these 107 NPC cases exhibited such a window. Cases that did not may reflect individual antibody response to EBV. Serologic screening at enrollment identified those cases who had already entered the window and became clinically manifested earlier (median=28 months) than those who entered the window after enrollment (median=90 months). The former account for 19 of 21 cases diagnosed within 2 years of screening. Nasopharyngeal carcinoma risk levels among seropositive subjects were also highest during this period. Both prediction rates and risk levels declined thereafter; cases detected at later times were composed of increasing proportions of individuals who entered the serological window after screening. Our findings establish EBV antibody as an early marker of NPC and suggest that repeated screening to monitor cases as they enter this window has considerable predictive value, with practical consequences for cancer treatment.