摘要
Nasopharyngeal carcinoma(NPC)has been a focus of medical research for more than 100 years,with significant interest emerging over the last 58 years following the identification of the link between the disease and Epstein-Barr virus(EBV)infection.NPC possesses several distinctive characteristics among human cancers,notably its well-documented global epidemiology,which reveals localized high-incidence regions primarily in Southeast Asia,particularly in the Southern provinces of China near the Pearl river,as well as in Greenland and North Africa.Epidemiological data indicate a marked male predominance,early disease onset,and a nearly 100%prevalence of latent EBV infection in the tumors.Due to lack of consistent pattern of cancer-related mutations in NPC genomes and excessive DNA-methylation in the tumor cells,NPC can be considered"an epigenetic cancer".Despite extensive researches,convincing biological explanations for these unique characteristics remain elusive.Recently,suggestive evidence has been published that specific local variants of EBV may represent major high risk factors.In spite of tumor and virus specific immunity,it has not been possible to use this for improved treatment.Ongoing studies on the role of the local microflora and tumor microenvironment are essential for a comprehensive understanding of host-EBV-tumor interactions.Ultimately,this knowledge aims to enhance diagnosis,disease fractionation,treatment strategies,and potentially prevention of NPC.
鼻咽癌作为医学研究的重要主题已逾百年。自58年前首次揭示其与EB病毒感染之间的紧密联系以来,这一领域逐渐成为研究的热点。在人类癌症中,鼻咽癌有几个与众不同的特点。特别是全球流行病学研究明确指出,鼻咽癌局部高发地区主要在东南亚,尤其是中国南方珠江流域及其周边省份,以及格陵兰岛和北非。流行病学数据表明,鼻咽癌患者中男性居多,发病较早,肿瘤中EB病毒潜伏感染率近乎百分之百。鉴于鼻咽癌缺乏一致的癌症相关突变模式以及肿瘤细胞中存在DNA高甲基化现象,鼻咽癌被视为一种“表观遗传癌症”。尽管开展了广泛的研究,但这些独特特征仍未得到令人信服的生物学解释。近期研究揭示了EB病毒的一种或多种局部变异可能是鼻咽癌的主要高危因素。尽管存在肿瘤和病毒特异性免疫,但仍无法利用这种免疫改善治疗。要全面了解宿主—EBV—肿瘤之间的相互作用,就必须不断研究鼻咽部微生物菌群和肿瘤微环境的作用。最终,我们将利用这些知识加强鼻咽癌的诊断、疾病分型、治疗策略和潜在预防。
出处
《广西医科大学学报》
CAS
2024年第9期1227-1236,共10页
Journal of Guangxi Medical University
