摘要
目的 探讨EBV-DNA定量检测对于局部晚期鼻咽癌肿瘤患者进行放化疗治疗后疗效及随访中出现肿瘤复发转移进行诊断的意义.方法 采用荧光定量PCR技术对173例经诊断为局部晚期鼻咽癌患者的放化疗联合治疗前及治疗0、2、4、6、8周的血浆EBV-DNA水平进行检测,同时对156例治疗前血浆EBV-DNA检测为阳性的患者进行治疗后6、12、18、24个月的血浆EBV-DNA进行检测并对其肿瘤复发转移情况进行统计.分析血浆EBV-DNA水平与患者治疗效果及治疗后2年随访出现肿瘤复发的相关性.结果 173例患者的血浆EBV-DNA检出阳性为156例,阳性检出率达90.2％,并且8周血浆EBV-DNA检出阳性率较之出现显著降低（P＜0.001）.另外,对完全缓解组及部分缓解组患者的8周血浆EBV-DNA检出阳性率进行比较,结果表明完全缓解组患者8周血浆EBV-DNA检出阳性率明显降低（P ＜0.001）.对143例治疗前血浆EBV-DNA阳性的患者随访情况分析表明,1、2年血浆EBV-DNA检测水平分别对患者1、2年复发转移的诊断灵敏度及特异性较高,ROC曲线Az分别为0.964、0.892（P ＜0.001）.结论 血浆EBV-DNA定量检测能够较好反映局部鼻咽癌晚期患者的放化疗疗效并且其在患者2年随访出现肿瘤复发转移中具有较高的诊断价值.
Objective To explore the clinical value of EBV-DNA quantitative detection in treatment and follow-up of metastasis and recurrence of cancer in patients with locally advanced nasopharyngeal carcinoma.Methods Quantitative real-time PCR was used to detect plasma EBV-DNA in 173 cases of patients before and 0,2,4,6 and 8 weeks after the radiochemotherapy treatment,and also used to detect plasma EBV-DNA at 6,12,18 and 24 months after the treatment in 156 cases of patients whose EBV-DNA was positive before treatment.The clinical effect of plasma EBV-DNA level in assessment of effect of treatment and cancer＆#39; s metastasis and recurrence during 2 years＆#39; of follow-up was analyzed.Results The positive rate of the 156 cases of patients was 90.2% and the positive rate of plasma EBV-DNA significantly decreased at 8 weeks after treatment （P 〈 0.001）.Plasma EBV-DNA level of patients in complete-response group is significantly lower than that of partial-response group at 8 weeks after the treatment （P 〈 0.001）.The follow-up results of 143 positive cases of patients before treatment shows that 1 or 2-year plasma EBV-DNA levels were higher judged on specificity and sensitivity of 1 or 2-year recurrence rate of nasopharyngeal carcinoma （Az =0.964、0.892;P 〈0.001）.Conclusions Plasma EBV-DNA quantitative detection can reflect the effect of radiochemotherapy treatment and recurrence of carcinoma in patients with locally advanced nasopharyngeal carcinoma.
出处
《国际病毒学杂志》
2015年第4期281-285,共5页
International Journal of Virology
关键词
EB病毒
鼻咽癌
疗效
肿瘤复发
Epstein-Barr virus
Nasopharyngeal carcinoma
Clinical effect
Recurrence of carcinama
