Muir C S
Bull Cancer. 1975 Jul-Sep;62(3):251-264.
While rare in most parts of the world, cancer of the nasopharynx is shown to be very common in Southern Chinese whether living in South China or elsewhere, is of intermediate level in a variety of Mongoloid populations such as Malays, Thais, Javanese and Vietnamese and the indigeneous peoples of Borneo, yet uncommon in North China and very rare in Japan. Moderate frequencies are seen in parts of the Maghreb, Malta, the Sudan and possibly East Africa. Occupational risk has not been demonstrated and case-control studies have generally been negative. Studies of migrants, notably Chinese of the US, have shown a diminution of mortality for the second and third generation, yet their risk still remains much higher than for white Americans. There is no convincing evidence of elevated risk among low-risk Caucasian populations living in South East Asia. The above findings, which have been held to indicate a genetic predisposition to an unknown environmental agent, are reviewed in the light of the recent discoveries of a characteristic HL-A profile in the high risk Cantonese. Several investigations of the HL-A profiles of groups of contrasting incidence are suggested as these may be of significance in relation to the postulated causal role of the Epstein-Barr virus for this neoplasm.
鼻咽癌在世界大部分地区都很罕见,但在中国南方,无论居住在中国南方还是其他地方,鼻咽癌都非常常见;在各种蒙古人种群体中,如马来人、泰国人、爪哇人和越南人以及婆罗洲的原住民中,鼻咽癌发病率处于中等水平;而在中国北方则不常见,在日本极为罕见。在马格里布部分地区、马耳他、苏丹以及可能在东非,鼻咽癌发病率处于中等水平。尚未证实职业风险,病例对照研究总体呈阴性。对移民的研究,尤其是对美籍华人的研究表明,第二代和第三代移民的死亡率有所下降,但其风险仍远高于美国白人。没有令人信服的证据表明生活在东南亚的低风险高加索人群的风险增加。鉴于最近在高危广东人群中发现了特征性的HL-A谱型,对上述表明对未知环境因素存在遗传易感性的研究结果进行了综述。建议对发病率不同的群体进行HL-A谱型的多项调查,因为这些调查可能与爱泼斯坦-巴尔病毒对该肿瘤的假定致病作用有关。