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目的 分析488 683人鼻咽癌普查结果,其中20 726人是广西梧州市鼻咽癌高发现场1980 年普查及10 年追踪观察和对查出EB病毒IgA/VCA抗体阳性者20年追踪观察结果,467 957人是现场以外其它地区普查结果,两者结果比较分析提出鼻咽癌普查和社区应用基本方案。方法 应用免疫酶法检测EB病毒IgA/VCA抗体,间接鼻咽镜配合,在现场和现场以外其它地区进行鼻咽癌普查。结果 现场20 726人普查及10年和20 年追踪观察,IgA/VCA抗体阴性19 590 人10 年内发生鼻咽癌4例,其中3例确诊时IgA/VCA抗体已显阳性反应,仅1 例仍为阴性,IgA/VCA抗体阳性1 136 人普查及20 年追踪观察检出鼻咽癌60例,其中接受随访的54例中,有46例属早期,早诊率85.2%,IgA/VCA抗体诊断鼻咽癌符合率98.3%。现场以外其它地区普查467 957人,检出鼻咽癌188例,其中属于早期患者为164 例,早诊率87.2%,可以重复现场结果。结论 免疫酶法检测EB病毒IgA/VCA抗体普查鼻咽癌,间接鼻咽镜配合,方法简单、价廉、诊断符合率高,可以检出鼻咽癌早期病人,是鼻咽癌普查或社区服务的首选基本方案,其它抗体检测可在这基础上互补,符合成本效益卫生经济学观点。
Objective To analyze the results of 488 683 NPC surveys, of which 20 726 were followed up by 1980 census and 10-year follow-up observation of high incidence of nasopharyngeal carcinoma in Wuzhou city of Guangxi and 20 years follow-up of detection of Epstein-Barr virus IgA / VCA antibody positive. 467 957 people were surveyed in other areas outside the site. The results of the two analyzes were compared and the basic plan of census of nasopharyngeal carcinoma and community application was proposed. Methods Immuno-enzyme-linked immunosorbent assay (ELISA) was used to detect Epstein-Barr virus IgA / VCA antibody. Indirect nasopharyngoscopy was used to screen the nasopharyngeal carcinoma in the field and other areas. Results A total of 20 726 censuses and 10 years and 20 years of follow-up were observed. Negative IgA / VCA antibody was found in 19 590 patients with nasopharyngeal carcinoma in 4 cases within 10 years, of which 3 cases had positive IgA / VCA antibodies when diagnosed, Were negative, IgA / VCA antibody-positive screening of 1 136 people and 20 years of follow-up observation of nasopharyngeal carcinoma in 60 cases, of which 54 cases were followed up, 46 cases of early, early diagnosis rate of 85.2%, IgA / VCA antibody diagnosis Nasopharyngeal carcinoma coincidence rate of 98.3%. 467 957 people were surveyed in other areas outside the scene, 188 cases of nasopharyngeal carcinoma were detected, of which 164 cases were early stage and the diagnosis rate was 87.2%. Field results could be repeated. Conclusion The detection of Epstein-Barr virus (IgA) / VCA antibody by immunoenzymatic method for screening nasopharyngeal carcinoma and indirect nasopharyngoscopy is simple and inexpensive, and the diagnostic coincidence rate is high. It can detect nasopharyngeal carcinoma early patients and is the screening or community service of nasopharyngeal carcinoma The first choice of the basic program, other antibody tests can be based on this complement each other, in line with cost-effective health economics point of view.