血浆EB病毒DNA与鼻咽癌预后关系的临床观察  

Relationship between Epstein-Barr virus DNA and prognosis in patients with nasopharyngeal carcinoma

作　　者：丁乃昕 张楠[1,2] 黄生富 何侠[1,2] 陈震章 DING Naixin;ZHANG Nan;HUANG Shengfu;HE Xia;CHEN Zhenzhang(Department of Radiotherapy,Nanjing Medical University Affiliated Cancer Hospital, Nanjing 210009, China)

机构地区：[1]南京医科大学附属肿瘤医院江苏省肿瘤医院放疗科,南京210009 [2]江苏省肿瘤防治研究所,210009

出　　处：《临床肿瘤学杂志》2021年第10期885-890,共6页Chinese Clinical Oncology

摘　　要：目的探讨血浆EB病毒DNA(Epstein-Barr virus DNA,EBV DNA)水平与鼻咽鳞癌预后之间的关系。方法回顾性分析2012年1月至2014年12月我院初治319例无远处转移鼻咽癌患者,均行调强放疗联合或不联合辅助化疗,随访记录患者的生存、复发、转移情况。所有患者在治疗前、放疗结束时、治疗后随访期检测血浆EBV DNA,比较治疗前、放疗结束时血浆EBV DNA的水平,分析血浆EBV DNA水平与患者的生存及肿瘤复发转移之间的关系。结果患者总体5年总生存率77%,5年无病生存率68.9%,5年无远处转移生存率84.9%。治疗前血浆EBV DNA阳性与阴性者、放疗结束时血浆EBV DNA阳性与阴性者5年总生存率、5年无病生存率、5年无远处转移生存率分别为:71.2%和90.6%,62.2%和86.1%,80.7%和96%;35.6%和81.7%,34.4%和72.3%,44.7%和88.7%,差异具有统计学意义(P<0.05)。有局部复发的患者治疗前、放疗结束时的血浆EBV DNA水平高于无局部复发的患者,有远处转移的患者治疗前、放疗结束时的血浆EBV DNA水平也高于无远处转移的患者(P<0.05)。多因素分析显示,N分期和放疗结束时的血浆EBV DNA水平是鼻咽癌预后的独立预后因素。结论血浆EBV DNA水平可作为判断鼻咽癌患者预后的重要血清学标志,治疗后随访期应复查血浆EBV DNA水平,对阳性者加强随访,以期及时发现局部复发或远处转移,予以挽救性治疗,改善患者预后。Objective To investigate the relationship between plasma level of Epstein-Barr virus DNA(EBV DNA)and prognosis of nasopharyngeal squamous cell carcinoma.Methods From January 2012 to December 2014,319 newly treated patients with nasopharyngeal carcinoma without distant metastasis in our hospital were retrospectively analyzed,all of whom received intensity modulated radiotherapy combined with or without adjuvant chemotherapy.The survival,recurrence and metastasis of the patients were followed up and recorded.Plasma EBV DNA was detected in all patients before treatment,at the end of radiotherapy,and in the follow-up period after treatment.Plasma EBV DNA levels were compared before treatment and at the end of radiotherapy,and the relationship between plasma EBV DNA levels and patient survival and tumor recurrence and metastasis was analyzed.Results The 5-year overall survival rate was 77%,the 5-year disease-free survival rate was 68.9%,and the 5-year distant metastasis free survival rate was 84.9%.The 5-year overall survival rate,5-year disease-free survival rate,and 5-year distant metastasis free survival rate were 71.2%and 90.6%,62.2%and 86.1%,80.7%and 96%,respectively,in patients with positive and negative plasma EBV DNA before treatment and at the end of radiotherapy.35.6%and 81.7%,34.4%and 72.3%,44.7%and 88.7%were statistically significant(P<0.05).The plasma EBV DNA level of patients with local recurrence before treatment and at the end of radiotherapy was higher than that of patients without local recurrence,and the plasma EBV DNA level of patients with distant metastasis before treatment and at the end of radiotherapy was also higher than that of patients without distant metastasis(P<0.05).Multivariate analysis showed that N stage and plasma EBV DNA level at the end of radiotherapy were independent prognostic factors of nasopharyngeal carcinoma.Conclusion Plasma EBV DNA level can be used as an important serological marker for the prognosis of patients with nasopharyngeal carcinoma.The plasma EBV DNA level shou

关 键 词：鼻咽鳞癌 EB病毒DNA 预后 

分 类 号：R739.62[医药卫生—肿瘤]