EBV VCA-IgA抗体在局部晚期鼻咽癌治疗前后检测的意义及与患者临床特征的关系  

The Significance of EBV VCA-IgA Antibodies in the Detection Before and After the Treatment of Locally Advanced Nasopharyngeal Carcinoma and Its Relation with the Clinical Features of Patients

作　　者：邹喜[1,2] 张纬建[1,2] 洪金省[1,2] 陈金梅[1,2] 刘锋[1] 

机构地区：[1]福建医科大学附属第一医院放疗科,福州350005 [2]放射生物福建省高等学校重点实验室(福建医科大学),福州350005

出　　处：《保健医学研究与实践》2015年第6期36-39,共4页Health Medicine Research and Practice

摘　　要：目的探讨局部晚期鼻咽癌患者治疗前后血清EB病毒衣壳抗原IgA（EBV VCA-IgA）抗体水平变化的临床意义及其与患者临床特征的关系。方法回顾性分析2014年3-10月在福建医科大学附属第一医院放疗科就诊的51例经病理证实为局部晚期鼻咽癌患者的病历资料,探讨治疗前患者血清EBV VCA-IgA水平与患者临床特征的关系,并对患者化放疗前后的EBV VCA-IgA水平进行配对比较。结果 51例患者治疗前EBV VCA-IgA的S/CO值为3.88（2.14,6.05）,EBV VCA-IgA抗体阳性率为94.1%,按不同性别、年龄、T分期、N分期、总分期、既往有无吸烟史进行分组比较,抗体阳性率差异均无统计学意义。诱导化疗2个周期后放疗前进行EBV VCA-IgA复查的患者有20例,与诱导化疗前进行配对比较,诱导化疗后EBV VCAIgA的S/CO值为3.99（2.09,5.22）,低于诱导化疗前的4.09（2.16,6.20）,但差异无统计学意义（Z=-0.845,P=0.398）;诱导化疗2个周期后放疗前EBV VCA-IgA抗体阳性率为85.0%,低于诱导化疗前的95.0%,但差异无统计学意义（χ~2=-0.278,P=0.598）。诱导化疗2个周期＋根治性放疗后进行了EBV VCAIgA复查的患者有31例,与治疗前进行配对比较,放疗后EBV VCA-IgA的S/CO值为2.30（1.35,5.20）,低于治疗前的3.91（2.20,6.43）,但差异无统计学意义（Z=-1.744,P=0.081）;诱导化疗2个周期＋根治性放疗后EBV VCA-IgA抗体阳性率为87.1%,低于化放疗前的93.5%,但差异无统计学意义（χ~2=-0.185,P=0.668）。结论 EBV VCA-IgA用于局部晚期鼻咽癌的治疗效果评估参考价值有限,其治疗前水平的临床影响因素尚有待进一步研究。Objective To investigate the clinical significance of changes of serum EB virus capsid antigen IgA （EBV VCA-IgA） antibodies in the detection before and after the treatment of locally advanced nasopharyngeal carcinoma and its relation with the clinical features of patients. Methods Medical records of 51 cases of pa- tients with locally advanced nasopharyngeal carcinoma pathologically confirmed from March to October 2014 in the first Affiliated Hospital of Fujian Medical University were retrospectively analyzed to explore the relation bdween levels of pre-treatment serum EBV VCA-IgA and patients＇ clinical features and compare the EBV VCA-IgA levels before and after radiotherapy. Results Before treatment, the value of S/CO of EBV VCA- IgA was 3.88 （2.14,6.05）, the positive rate of EBV VCA-IgA antibodies was 94.1%, and there were no sig nificant differences of positive rates in groups of different gender, age, T stage, N stage, overall stage and smoking history. 20 cases of patients were reexamined EBV VCA-IgA after two courses of induction chemo- therapy before radiotherapy; the value of S/CO of EBV VCA IgA after chemotherapy was 3.99 （2.09,5.22）, lower than 4.09 （2.16,6.20） of before chemotherapy, but the difference was not statistically significant （Z ： 0.845, P=0.398）; the positive rate of EBV VCA-IgA antibodies was 85.00/oo, less than 95.0% of before chemotherapy and the difference was not statistically significant （X2 =- 0. 278, P ： 0. 598）. 31 cases of pa-tients were reexamined EBV VCA-IgA after two courses of induction chemotherapy and radical radiotherapy; the value of S/CO of EBV VCA-IgA after radiotherapy was 2.30 （1.35,5.20）, lower than 3.91（2.20,6.43） of before treatment, but the difference was not statistically significant （Z = - 1. 744, P = 0.081 ） ; the positive rate of EBV VCA-IgA antibodies after chemotherapy and radiotherapy was 87.1%, less than 93.5% of before chemotherapy and the difference was not statistically significant （x2 =-0.185, P=0.668）. Con

关 键 词：EB病毒衣壳蛋白抗体 鼻咽癌 化疗 放疗 临床特征 

分 类 号：R739.63[医药卫生—肿瘤]