Schetter Aaron J, You Wei-cheng, Lennette Evelyne T, Gail Mitchell T, Rabkin Charles S
Cancer Prevention Fellowship Program, National Cancer Institute, National Institute of Health, 6120 Executive Boulevard, Bethesda, MD 20892-7335, USA.
Cancer Sci. 2008 Feb;99(2):350-4. doi: 10.1111/j.1349-7006.2007.00668.x. Epub 2008 Jan 14.
We evaluated associations between Epstein-Barr virus (EBV) antibody levels and precancerous gastric lesions (chronic atrophic gastritis, intestinal metaplasia, and dysplasia) in 183 subjects from Linqu, China. Immunoglobulin G antibody titers to EBV nuclear antigen (EBNA) and viral capsid antigen (VCA) were determined by two-fold serial dilution using immunofluorescence assays. Histological progression and regression were assessed by gastroscopic examination at the time of phlebotomy and at follow up 2 years later. Antibody titers did not differ significantly among histological diagnoses determined at the time of phlebotomy. However, subjects with dysplasia at follow up had significantly higher geometric mean antibody titers for both anti-VCA and anti-EBNA. Subjects with greater than median antibody levels were more likely to progress between examinations, especially in the subgroup with intestinal metaplasia at the time of phlebotomy (odds ratios [95% confidence intervals]: 5.7 [1.6-20] for anti-EBNA >or=1:320; 3.8 [1.0-15] for anti-VCA >or=1:640). Our findings suggest a possible role for EBV reactivation at an early phase of gastric carcinogenesis.
我们评估了来自中国临朐的183名受试者中，爱泼斯坦-巴尔病毒（EBV）抗体水平与癌前胃病变（慢性萎缩性胃炎、肠化生和发育异常）之间的关联。采用免疫荧光法通过两倍连续稀释法测定针对EBV核抗原（EBNA）和病毒衣壳抗原（VCA）的免疫球蛋白G抗体滴度。在采血时和2年后随访时通过胃镜检查评估组织学进展和消退情况。在采血时确定的组织学诊断中，抗体滴度没有显著差异。然而，随访时出现发育异常的受试者，其抗VCA和抗EBNA的几何平均抗体滴度显著更高。抗体水平高于中位数的受试者在两次检查之间更有可能出现病情进展，尤其是在采血时存在肠化生的亚组中（比值比[95%置信区间]：抗EBNA≥1:320时为5.7[1.6 - 20]；抗VCA≥1:640时为3.8[1.0 - 15]）。我们的研究结果表明，EBV重新激活在胃癌发生的早期阶段可能发挥作用。
