EB-DNA检测对鼻咽癌早期诊断及预后评估的临床意义  

Clinical Significance of EB-DNA Detection in Early Diagnosis and Prognosis Evaluation of Nasopharyngeal Carcinoma

作　　者：尚洁 高娟[1] 杨青[1] SHANG Jie;GAO Juan;YANG Qing(Xi'an High-tech Hospital,Xi'an,710000)

机构地区：[1]陕西省西安高新医院,710000

出　　处：《实用癌症杂志》2020年第11期1838-1841,共4页The Practical Journal of Cancer

基　　金：榆林市科学技术项目(编号:201904)。

摘　　要：目的探究EB-DNA检测在鼻咽癌患者早期诊断及预后评估中的应用价值。方法选择93例鼻咽癌患者为研究对象,按照病情分别将其分为A组(初诊33例)、B组(放疗后病情持续缓解者20例)、C组(放疗后病情出现远处转移24例)和D组(放疗后出现局部复发者16例),另选同期接受体格检查的30例健康个体为健康对照组,选取同期确诊为非鼻咽癌的30例患者为病例对照组,分别检测其血浆EB-DNA含量并进行组间对比。结果(1)A组患者EB-DNA检出率为93.94%,B组为55.00%,C组为95.83%,D组为93.75%,对照组检出率为3.33%,病例对照组检出率为13.33%,鼻咽癌A、C、D 3组患者EB-DNA检出率明显高于B组、健康对照组和病例对照组(P<0.05)。(2)将A组患者按照TNM分期进行对比,发现T3~T4期患者EB-DNA中位拷贝数高于T1~T2期患者,N0~N1期患者EB-DNA中位拷贝数低于N2~N3期患者,M0期患者EB-DNA中位拷贝数低于M1期患者(P<0.05)。(3)对A组患者实施治疗并按照治疗结局区分为出现局部转移或复发组以及未出现复发转移组,对比显示未出现复发转移组患者治疗前EB-DNA中位拷贝数明显低于出现局部转移或复发组患者(P<0.05)。(4)将33例初诊患者按照EB-DNA中位数将其分为≥40000拷贝/ml(15例)和<40000拷贝/ml(18例)2组,随访20个月≥40000拷贝/ml患者无复发生存率为46.67%(7/15),<40000拷贝/ml患者为88.89%,2组对比差异具有统计学意义(P<0.05)。结论EB-DNA检测在鼻咽癌早期诊断及预后判断中具有较重要的临床意义,能够用于评估鼻咽癌分期、远处转移、复发等指标,有可能成为鼻咽癌的重要血清学标志物。Objective To explore the application value of EB-DNA detection in early diagnosis and prognosis evaluation of patients with nasopharyngeal carcinoma.Methods 93 patients with nasopharyngeal carcinoma diagnosed were selected as subjects,and were divided into the group A(33 cases initially diagnosed),the group B(20 cases with persistent disease after radiotherapy),the group C(24 cases with distant metastasis after radiotherapy)and the group D(local recurrence after radiotherapy 16),another 30 healthy individuals who underwent physical examination in our hospital during the same time were used as the control group,select 30 patients diagnosed as non-nasopharyngeal carcinoma in the same period as the case control group,and their plasma EB-DNA levels were detected and compared between the 2 groups.Results(1)The detection rate of EB-DNA in the group A was 93.94%,55.00%in the group B,95.83%in the group C,93.75%in the group D,and 3.33%in the control group,and the detection rate in the case control group 13.33%.The rate of EB-DNA was significantly higher in the group A,C and D than in the group B,the control group and the case control group(P<0.05).(2)Comparing patients in group A according to TNM staging,it was found that the median copy number of EB-DNA in patients in stagesⅢtoⅣwas higher than that in patients in stagesⅠtoⅡ,and the median copy number of EB-DNA in patients in stages N0 to N1 was lower than that in patients from stages N2 to N3.,The median copy number of EB-DNA in T1~T2 patients is lower than that in T3~T4 patients.(3)Patients in group A were treated and divided into groups with local metastasis or recurrence and non-relapsed metastasis group according to treatment outcome.The comparison showed that the number of EB-DNA median copy number in patients without recurrence and metastasis was significantly lower than that in patients with local metastasis or recurrence(P<0.05).(4)33 newly diagnosed patients were divided into≥40000 copies/ml(15 cases)and<40000 copies/ml(18 cases)according to the EB-DNA

关 键 词：EB-DNA 鼻咽癌 早期诊断 预后评估 临床意义 

分 类 号：R739.63[医药卫生—肿瘤]