复发转移鼻咽癌患者血浆EB病毒DNA水平的检测意义  

Quantitative Analysis of Plasma EBV DNA Levels in Recurrent and Metastatic Nasopharyngeal Carcinoma Patients

作　　者：彭培建[1] 廖海[2] 林忠[1] 肖妹[1] 

机构地区：[1]中山大学附属第五医院肿瘤化疗科,广东省珠海市519000 [2]中山大学附属肿瘤医院内科,广州市510060

出　　处：《中华全科医学》2009年第6期570-571,共2页Chinese Journal of General Practice

摘　　要：目的探讨定量检测鼻咽癌患者血浆EB病毒(EBV)DNA水平在监测复发转移方面的临床意义,并与VCA-IgA、EA-IgA进行比较分析。方法对21例临床缓解期患者和25例临床复发转移患者的血浆,用荧光定量PCR的方法,在PE7700型检测仪上定量检测血浆标本中EBV-DNA水平,免疫酶法检测VCA-IgA、EA-IgA水平。结果肿瘤复发转移组92%(23/25)的患者血浆中可检测到高拷贝数的EBV-DNA,中位浓度为420000copies/ml,在临床缓解组患者中,仅4.8%(1/21)的患者血浆中可检测到较高拷贝数的EBV-DNA,中位浓度为0copies/ml。两组阳性率及中位浓度的比较差异均有统计学意义(P<0.001);两组患者VCA-IgA、EA-IgA水平未见明显差异(P>0.05)。结论血浆EBV-DNA水平的检测有助于鼻咽癌复发转移的诊断,其预后价值优于VCA-IgA、EA-IgA水平的检测。Objective To evaluate the significance of quantitative analysis of plasma EBV DNA for monitoring of tumor recurrence and metastasis in Nasopharyngeal carcinoma （ NPC ） patients after treatment and compare with VCA-IgA and EA-IgA. Methods EBV-DNA, VCA-IgA and EA-IgA levels in plasma were detected in different NPC patients including 21 still in remission patients and 25 patients with evidence of tumor recurrence or distant metastasis. EBV-DNA was detected by using fluorescent quantitative PCR method in the PE Appliance Biosystems 7 700 sequence Detector. VCA-IgA and EA-IgA were tested using regular immunoenzyme method. Results A high plasma EBV DNA level could be detected in 92% （23/25） patients with recurrence or distant metastasis disease, the median concentration was 420 000 copies/ml, whereas only 4.8% （ 1/21 ） patients with continuous remission could be detected a high level ,the median concentration was 0 copies/ml（ P 〈0.001 ）. The levels of VCA-IgA and EA-IgA had no significant difference between the both groups （ P 〉 0.05 ）. Conclusion Plasma EBV DNA may be a valuable index for diagnosing tumor recurrence or metastasis in nasopharyngeal carcinoma patients after treatment and is more valuable than VCA-IgA and EA-IgA.

关 键 词：鼻咽肿瘤 荧光定量PCR 血浆 EBV-DNA 

分 类 号：R739.63[医药卫生—肿瘤]