EBV-DNA阳性对鼻咽癌放疗后复发转移影响的探讨  

Clinical value of positive detection of EBV-DNA in the patients with recurrence or metastasis of nasopharyngeal carcinoma after radiotherapy

作　　者：金雯雯[1] 王业涛[2] 王力[3] 张红雁[1] 

机构地区：[1]安徽省立医院肿瘤放疗科,安徽合肥230001 [2]安徽省立医院消化内科,安徽合肥230001 [3]安徽省立医院检验科,安徽合肥230001

出　　处：《中华肿瘤防治杂志》2017年第20期1473-1475,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的调强放疗治疗鼻咽癌的局部控制率及5年生存率均较高,但仍有部分完全缓解的患者出现局部复发及远处转移。本研究探讨EBV-DNA阳性在鼻咽癌局部复发或远处转移中的临床意义。方法选择在安徽省立医院肿瘤放疗科随诊的放疗后局部晚期鼻咽癌患者70例,其中持续缓解组45例,复发或转移组25例。比较持续缓解患者与复发或转移患者血液中EBV-DNA的阳性检出率。结果持续缓解组EBV-DNA阳性检出率为4.44%(2/45),中位拷贝数为0;复发或转移组EBV-DNA阳性检出率为80.00%(20/25),中位拷贝数为0.619×103。两组阳性检出率差异有统计学意义,χ2=39.34,P<0.01;两组中位拷贝数差异有统计学意义,P<0.01。结论 EBV-DNA阳性可以作为监测鼻咽癌放疗后复发或转移的敏感指标。OBJECTIVE The local control rate and 5-year survival rate of nasopharyngeal carcinoma are higher in the period of intensity-modulated radiotherapy, but there are still some patients with complete remission occurred local re- currence and distant metastasis. This study was to investigate the clinical significance of positive detection of EBV-DNA in patients with recurrence or metastasis of nasopharyngeal carcinoma （NPC）. METHODS Seventy patients with naso- pharyngeal carcinoma after radiotherapy in Anhui Provincial Hospital were selected, and the positive detection of EBVDNA in blood of clinical remission patients and recurrent or metastatic patients were compared. RESULTS Totally 80.00 % （20/25） of recurrent or metastatic patients were detectable for EBV-DNA, with media concentration of 0. 619 × 10^3 copies/mL, whereas only 4.44% （2/45） of clinical remission patients were detectable for EBV-DNA, with media concentration of 0 copy/mL. The detectable proportion and concentration in recurrent or metastatic patients were significantly higher than that in clinical remission（χ^2=39.34, P〈0.01）. The difference between the two groups was statistically significant （P〈0.01）. CONCLUSION The positive detection of EBV-DNA can be used as a sensitive indicator to monitor the recurrent or metastasis of nasopharyngeal carcinoma after radiotherapy, and to judge the prognosis of patients.

关 键 词：EBV-DNA 鼻咽癌 复发 转移 

分 类 号：R739.63[医药卫生—肿瘤]