EB病毒DNA血浆浓度评估NPC患者放疗敏感性的研究  

Value of plasma Epstein-Barr virus DNA content in assessment of radiosensitivity of patients with nasopharyngeal carcinoma

作　　者：张莉[1] 黄伟忠[1] 张鲍虎[1] 李长俊[1] 

机构地区：[1]深圳市坪山新区人民医院检验科,广东深圳518118

出　　处：《海南医学院学报》2013年第10期1396-1400,1405,共6页Journal of Hainan Medical University

基　　金：中国高校医学期刊临床专项资金项目(112210809)~~

摘　　要：目的:探讨血浆EBV DNA含量对评估初诊鼻咽癌(Nasopharyngeal carcinoma,NPC)患者放疗敏感性的临床意义。方法:采用荧光定量Real-time PCR技术分析230例(早期176例,中晚期54例)初诊NPC患者放疗前及放疗后1周、3个月、6个月、9个月、12个月患者血浆EBV DNA拷贝量,结合影像学检查结果判断患者对放疗的敏感性。结果:放疗前早期患者血浆EBV DNA含量43.8%(77/176)<4000copies/mL,16.5%(29/176)<500copies/mL。早期患者血浆EBV DNA中位浓度只有4324(17403-276)copies/mL,拷贝量随复诊时间推移逐渐降低,治疗后12个月早期患者血浆EBVDNA含量57.4%(101/176)<4000copies/mL,35.2%(62/176)<500copies/mL,15.9%(28/176)的早期患者影像学和鼻咽镜检查发现肿瘤体积消失;中晚期患者血浆EBV DNA中位浓度高达28035(42403-6752)copies/mL,治疗后12个月虽然也降低,但是33.3%(18/54)中晚期患者出现复发,9个中晚期患者(16.7%,9/54)淋巴结转移。结论:早期患者血浆EBV DNA含量放疗1年后明显降低,能够有效反应NPC患者放疗敏感性。中晚期患者血浆EBV DNA含量减少缓慢,且部分患者出现复发或转移,NPC患者放疗敏感性差。Objective：To study the clinical significance of plasma EBV DNA content in assessment the radiosensitivity of newly diagnosed patients with nasopharyngeal carcinoma（NPC）.Methods：Plasma EBV DNA content in 230cases（176early cases and 54advanced cases）of NPC before undergoing radiotherapy and at the first week,the third month,the sixth month,the ninth month,the twelfth month after radiotherapy were analyzed by fluorescence quantitative Real-time PCR.Radiosensitivity of patients and determined considering imaging examination results.Results：Plasma EBV DNA content of early diagnosed patients were 43.8%（77/176）4000copies/mL and 16.5%（29/176）500copies/mL before undergoing radiotherapy.The median concentration of the plasma EBV DNA in early referral patients was only 4324（17403-276）copies/mL,and 57.4%（101/176）4000copies/mL and 35.2%（62/176）500copies/mL at the twelfth month,respectively.Imaging examination revealed absence of tumor in 15.9%（28/ 176）of early diagnosed patients after radiotherapy.The median concentration of the plasma EBV DNA content in advanced patients reached up to 28035（42403-6752）copies/mL,although the plasma EBV DNA content decreased at the twelfth month,recurrence happened in 33.3%（18/54）cases,and lymph node metastasis happened in 9cases（16.7 %,9/54）.Conclusion：For early diagnosed patients,EBV DNA contents decreased indication the method can be used to evaluate the radiosensitivity of early NPC patients.But in advanced patients,EBV DNA contents decreased slowly thus it can not evaluate effectively the radiosensitivity of advanced NPC patients.

关 键 词：NPC EBVDNA 荧光定量PCR 放疗敏感性 

分 类 号：R739.6[医药卫生—肿瘤]