The diagnostic and prognostic values of plasma Epstein-Barr virus DNA for residual cervical lymphadenopathy in nasopharyngeal carcinoma patients:a retrospective study  

作　　者：Sai-Lan Liu Xue-Song Sun Xiao-Yun Li Lin-Quan Tang Qiu-Yan Chen Huan-Xin Lin Yu-Jing Liang Jin-Jie Yan Chao Lin Shan-Shan Guo Li-Ting Liu Yang Li Hao-Jun Xie Qing-Nan Tang Hu Liang Ling Guo Hai-Qiang Mai 

机构地区：[1]State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy,Sun Yat-sen University Cancer Center,Guangzhou 510060,Guangdong,P.R.China [2]Department of Nasopharyngeal Carcinoma,Sun Yat-sen University Cancer Center,Guangzhou 510060,Guang-dong,P.R.China [3]Department of Radiation Oncology,Sun Yat-sen University Cancer Center,Guangzhou 510060,Guangdong,P.R.China

出　　处：《Cancer Communications》2019年第1期135-147,共13页癌症通讯（英文）

基　　金：This study was supported by grants from the National Key R&D Program of China(2016YFC0902003,2017YFC1309003,2017YFC0908500);the National Natural Science Foundation of China(No.81425018,No.81672868,No.81602371,No.81572848,No.81772877,No.81372814,No.81773103);the Sun Yat-sen University Clinical Research 5010 Program,the Sci-Tech Project Foundation of Guangzhou City(201707020039);the National Key Basic Research Program of China(No.2013CB910304);the Special Support Plan of Guangdong Province(No.2014TX01R145);the Sci-Tech Project Foundation of Guangdong Province(No.2014A020212103,No.2012B031800255,No.2014A020212528);Guangzhou Science and Technology Planning Project China(No.2014J4100181);the Health&Medical Collaborative Innovation Project of Guangzhou City(No.201400000001);the National Science&Technology Pillar Program during the Twelfth Five-year Plan Period(No.2014BAI09B10);the PhD Start-up Fund of Natural Science Foundation of Guangdong Province,China(2016A030310221);the Cultivation Foundation for Junior Teachers of Sun Yat-sen University(16ykpy28);the Fundamental Research Funds for the Central Universities

摘　　要：Background:Currently,the diagnosis and treatment of nasopharyngeal carcinoma(NPC)patients with residual cervical lymphadenopathy following radical radiotherapy with or without chemotherapy are challenging.We investigated the prognosis of NPC patients with residual cervical lymphadenopathy and assessed the diagnostic and prognostic values of Epstein-Barr virus(EBV)DNA in these patients.Methods:This study included 82 NPC patients who were diagnosed with suspected residual cervical lymphadenopathy following completion of antitumor therapy.Their plasma EBV DNA levels were measured using quantitative polymerase chain reaction(qPCR)before the initiation of treatment and before neck dissection.Fine needle aspiration cytology(FNAC)was performed in 21 patients.All patients had undergone neck dissection and postoperative pathological examination to identify the nature of residual cervical lymphadenopathy.The overall survival(OS),progression-free survival(PFS),distant metastasis-free survival(DMFS),and locoregional relapse-free survival(LRRFS)were calculated using the Kaplan-Meier method and compared using the log-rank test.The Cox proportional hazards model was used to calculate hazard ratios(HRs)with 95%confidence intervals(CIs).Multivariable analysis was used to estimate the effect of potential prognostic factors on survival.Results:Following a median follow-up of 52.6 months,compared with patients with negative postoperative pathological findings for residual cervical lymphadenopathy,the patients with positive findings had a significantly lower 3-year PFS rate(49.9%vs.83.3%,P=0.008).Among NPC patients with residual cervical lymphadenopathy,the patients with preoperative plasma EBV DNA>0 copy/mL had a lower 3-year PFS rate than did those with no detectable EBV DNA(43.7%vs.61.1%,P=0.031).In addition,combining FNAC with preoperative EBV DNA detection improved the diagnostic sensitivity.Multivariable analysis demonstrated that residual cervical lymphadenopathy with positive postoperative pathological result was an independe

关 键 词：Nasopharyngeal carcinoma Residual cervical lymphadenopathy PROGNOSIS Epstein-Barr virus Fine needle aspiration cytology SURVIVAL 

分 类 号：R73[医药卫生—肿瘤]