摘要
目的探讨患鼻咽癌不同风险人群的复查间隔时间与鼻咽癌早期诊断的关系,及其对鼻咽癌筛查策略的影响。方法 2007年3月～2009年6月,通过鼻咽癌风险评估方案对9645名中山市户籍健康成人进行筛查,并对评估高、中、低各人群的随访资料进行比较,观察上述各类人群EB病毒血清学评估的变化规律及其与鼻咽癌发病的关系。结果首次筛查共检出高危1 7 8人,中危4 7 7人,低危8 9 9 0人,共检出8例鼻咽癌,其中首次筛查高危人群中检出5例鼻咽癌,首次筛查中、低危人群中未检出鼻咽癌;通过随访检出早期鼻咽癌3例。高危中8 5人(4 7.8%)参加了复查,其中1 7人复查时仍评估高危,复查间隔时间平均7.0 5个月,复查时检出鼻咽癌2人,间隔时间分别为3个月和6个月。鼻咽癌家系中1人首次筛查低危,间隔9个月复查转成中危,检出早期鼻咽癌;本组由中危转高危复查平均间隔时间为9个月,低危转高危为12.4个月,未检出鼻咽癌。结论首次评估高危人群和持续高危人群,以及鼻咽癌家系人群短期发病率均高于其他人群,建议6个月内密切随访;评估中、低危人群一次筛查后1～2年内患鼻咽癌的机会很低,不需要频繁检查,建议分别间隔15个月和18个月复查,能够达到早期发现鼻咽癌的目的。鼻咽癌高发区最好在门诊建立专科门诊,提高筛查依从性,最终达到提高门诊早诊率的目的。
Objective To probe the relationship between variation of follow-up interval and early diagnosis of nasopharyngeal carcinoma（NPC） in high risk population,and to explore the impact of this relationship on the NPC screening strategy.Methods From March 2007 to June 2009,9645 healthy adults in Zhongshan city were primarily screened for NPC and classified as high,moderate and normal risk groups.By following up subjects with different risk,the serological changes of Epstein-Barr virus were observed and their correlation with NPC incidences was analyzed.Results In the first screening,the case numbers of high,moderate,and slight risk were 178,477 and 8990 respectively.Clinical examination confirmed NPC in 8 cases,5 were among the 178 high risk subjects;there was mone among the slight risk group;and the other 3 were early diagnosed having NPC during the follow-up period.85（47.95%） with high risk were reexmined;17 were still of high risk for NPC and their average follow-up interval time was 7.05 months;2 were diagnosed having NPC with a follow-up interval of 3 and 6 months.In a NPC clan,one individual was of slight risk at the first screening and turned to moderate risk 9 months after,then early NPC diagnosis was established;the average follow-up interval for the moderate risk to the high risk was 9 months;the slight risk to high risk was 12.4 months and no NPC occured.Conclusion The preferable follow-up interval should be shorter than 6 months for high risk group and NPC clans.And for slight and moderate risk groups,the preferable intervals should be 1 to 2 years with an arerage of 15~18 months.In NPC high risk area,special clinic should be set up for improving the early diagnosis rate of NPC.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2011年第1期33-36,共4页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
基金
广东省中山市科技局课题资助项目(编号:20082A062)
中山市科技强医支撑项目(20083A183)
关键词
鼻咽癌
群体筛查
间隔时间
EB病毒
Nasopharyngeal carcinoma
Population screening
Follow-up interval
Epstein-Barr virus
