• 作者： 林宗洲; 杜詩綿
• 作者服務機構： 台大醫院耳鼻喉科
• 中文摘要： 在臺大醫院耳鼻喉科，經診斷為鼻咽癌且有病理切片證實之病患中，在照射治療之前後各時
  期採取血清檢體，以間接螢光抗體法檢定其中之IgA抗EB-VCA抗體。病人採取血清每人2
  次到6次之間，追?病情達3年到9年。
  自40例病人共得到113件血清檢體。其中20例病人在治療後有5年以上都在健康狀態，無復
  發跡象，歸為痊癒組。另外20例則有局部復發或遠隔轉移，歸為復發組。
  結果發現，痊癒組之病人，IgA抗體力價之幾何平均，在治療前為1：59，而治療後一直降
  低，第一年為1：33，第2年就降到1：12之低力價，第3年為1：17。相反地，在復發組，治
  療前為1：88，在治療結束時稍降低到1：53，但是以後一直增高，第一年為1：67到1：101
  ，第二年就升高到1：255之高力價，第3年為1：226。可見在鼻咽癌病人，如果照射治療成功
  的話，IgA抗EB-VCA抗體力價大致會一路降低。如果此抗體力價居高不下，或降低後再升高的
  話，很可能是癌症未癒，或癒而復發的情況。此時應該追加局部照射治療或全身的化學治療或免
  疫治療，以求增進病人的治癒率。
  的
• 英文摘要： Two to six serum samples were collectedfrom patients with Nasopharyngeal Carcinoma(NPC), histopathologically confirmed asanaplastic epidermoid carcinoma, before, during, and after irradiation therapy of about7,000 rads in six to eight weeks. Titrationof IgA antibodies against viral capsid antigen(VCA) of Epstein-Barr (EB) virus was doneby means of indirect immunofluorescent anti-body method. Patients survived in remission for morethan five years after radiotherapy withoutany evidence of cancer were grouped as "CuredPatients". The geometric mean titer (GMT)of IgA anti-EB-VCA antibodies in this groupof patients before treatment was 1：59, andthe GMTs were 1：34, 1：12, and 1：17 in thefirst, second and third year following radio-therapy. Therefore, the IgA antibody titersdecreases steadily in patients with successfulradiotherapy. In contrast, patients who eventuallydeveloped evidences of local recurrence and/ordistant metastases were grouped as "RecurrentPatients". The GMT of recurrent patientswas 1：88 before treatment, and it was 1：67to 1：101 in the first year, 1：255 in the secondyear and 1：226 in the third year followingradiotherapy. It is obvious that the IgA anti-body titre returned to high level within oneyear after radiotherapy. It is reasonable tospeculate that, if the existence of tumor tissueof NPC before treatment may cause increasedsynthesis of IgA antibody, the existence ofmicrometastases or residual tumors afterradiotherapy may also result in high level ofIgA antibody titers. Therefore, high titer ofIgA anti-EB-VCA in patients with NPC afterradiotherapy is a grave warning of existingor impending recurrence and/or metastases. Systemic chemotherapy and/or immunotherapyshould be carried out in addition to local radio-therapy in order to improve the survival ofthe patients.
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• 英文關鍵字： --