在高发地区筛查鼻咽癌——下一步行动

Screening for nasopharyngeal carcinoma in high-incidence regions——Next steps

  • 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 nonkeratinizing 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 diagnosed 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 implementing screening programs in high-incidence populations, assessing and refining screening algorithms, and exploring 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 implementation 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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