摘要
EB病毒感染是诱发非角化性未分化型鼻咽癌的关键因素,在中国及东南亚地区尤为普遍.早期诊断鼻咽癌对于显著提升患者存活率至关重要,早期鼻咽癌患者治疗后5年生存率可超过90%.研究证实,利用EBV标记进行鼻咽癌筛查能够精准识别患者.展望未来,我们的工作重心应聚焦于在高风险群体中推行筛查计划,持续评估和优化筛查算法,积极探索成本—效益更佳的新型筛查手段.值得注意的是,任何新方法在被广泛采用之前,都必须经过严格全面的验证,证明其优于或不亚于现有方法.这些筛查工具能否有效降低鼻咽癌相关的发病率与死亡率,关键在于其能否得到有效执行,并惠及亟需预防干预的目标人群.本文作为一篇观点性论述,简要归纳了支持基于EBV的鼻咽癌筛查的论据,并探讨了未来的三大行动方向:一是实施高效的鼻咽癌筛查计划;二是评估筛查方法的持续改进成效;三是探索并引入新的筛查方法.
Abstract
Epstein-Barr virus(EBV)infection is a well-established risk factor in the development of nonkera-tinizing and undifferentiated forms of nasopharyngeal carcinoma(NPC)common in parts of China and Southeast Asia.Early detection of NPC can significantly improve survival rates,as the 5-year survival rate for patients diag-nosed at an early stage can exceed 90%after treatment.Studies have demonstrated that screening for NPC using EBV markers is an effective tool for identifying individuals with the disease.Future efforts should focus on imple-menting screening programs in high-incidence populations,assessing and refining screening algorithms,and ex-ploring new,potentially more cost-effective screening methods.It is crucial to ensure that any new approaches are validated as superior or non-inferior to existing protocol before being adopted on a wider scale.The success of these screening tools in reducing NPC-related morbidity and mortality will depend on their effective implementa-tion and ensuring access for the populations most in need of preventive interventions.This opinion piece briefly summarizes the current evidence supporting EBV-based screening for NPC detection and discusses future steps,including:1)the implementation of effective NPC screening programs,2)the evaluation of improvements in screening methodologies,and 3)the consideration of novel approaches to screening.
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