EB病毒DNA拷贝量动态分析对晚期鼻咽癌患者化疗疗效的预测价值  

Predictive value of dynamic analysis of EB virus DNA copy quantity for chemotherapy efficacy in patients with advanced nasopharyngeal carcinoma

作　　者：喜燕[1] 唐亮[1] 艾力根·阿不都热依木[1] XI Yan;TANG Liang;Ailigen·Abudureyimu(Otolaryngology Diagnosis and Treatment Center,Xinjiang Uygur Autonomous Region People′s Hospital,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院耳鼻喉诊疗中心,新疆乌鲁木齐830001

出　　处：《国际检验医学杂志》2021年第23期2849-2854,共6页International Journal of Laboratory Medicine

基　　金：国家自然科学基金项目(81760023)。

摘　　要：目的探讨EB病毒DNA(EBV-DNA)拷贝量动态分析对晚期鼻咽癌(NC)患者化疗疗效的预测价值。方法选择2018年1月至2020年1月于该院接受标准化疗方案的晚期NC患者131例作为研究对象。所有患者分别于化疗前及化疗后采用聚合酶链反应检测血浆内EBV-DNA拷贝量,并计算治疗前后EBV-DNA拷贝量的差值及比值。收集所有患者临床资料、实验室检查资料及影像学检查资料,采用Logistic回归分析治疗前后EBV-DNA拷贝量动态分析结果与疗效的相关性,再采用受试者工作特征曲线分析EBV-DNA拷贝量动态分析结果对NC患者化疗疗效的预测价值,并比较各项指标之间的优劣性。结果131例患者经过治疗后获得完全缓解21例,获得部分缓解74例,有效共95例,最终分为有效组(95例)和无效组(36例)。有效组治疗前后EBV-DNA拷贝量均明显低于无效组,而治疗前后其拷贝量比值明显高于无效组,差异均有统计学意义(P<0.05)。有效组放疗例数占比明显高于无效组,而年龄明显低于无效组,差异均有统计学意义(P<0.05)。有效组乳酸脱氢酶(LDH)水平及最大病灶最大径均小于无效组,差异均有统计学意义(P<0.05)。治疗前EBV-DNA拷贝量(OR=1.789,95%CI:1.033~3.189)及LDH水平(OR=1.024,95%CI:1.011~1.039)是影响疗效的独立危险因素(P<0.05),而治疗前后EBV-DNA拷贝量比值(OR=0.775,95%CI:0.701~0.875)是影响疗效的独立保护因素(P<0.05),治疗前EBV-DNA拷贝量、治疗前后EBV-DNA拷贝量比值及LDH水平对NC患者化疗疗效的预测均有一定价值(P<0.05)。治疗前后EBV-DNA拷贝量比值及LDH水平对NC患者化疗疗效的预测效果均明显优于治疗前EBV-DNA拷贝量(Z=2.681、2.521,P=0.007、0.024),但二者之间预测效果比较,差异无统计学意义(Z=0.313,P=0.754)。结论EBV-DNA拷贝量动态监测对于晚期NC患者化疗疗效具有较好的预测价值,可以将其纳入评价NC患者化疗的体系中。Objective To explore the predictive value of dynamic analysis of EB virus DNA(EBV-DNA)copy quantity for chemotherapy efficacy in patients with advanced nasopharyngeal carcinoma(NC).Methods A total of 131 patients with advanced NC who received standard chemotherapy in this hospital from January 2018 to January 2020 were selected as the research objects.All patients used polymerase chain reaction to detect the EBV-DNA copy quantity in plasma before and after chemotherapy.The difference and ratio of EBV-DNA copy quantity before and after treatment were calculated.Collected clinical data,laboratory examination data and imaging examination data of all patients.Logistic regression analysis was used to analyze the correlation between the results of dynamic analysis of EBV-DNA copy quantity and curative effect before and after treatment.The receiver operating characteristic curve was used to analyze the predictive value of EBV-DNA copy quantity dynamic analysis results for the chemotherapy effect of NC patients,and to compare the advantages and disadvantages of various indicators.Results After treatment,21 patients achieved complete remission,74 patients achieved partial remission,and 95 patients were effective.Finally,they were divided into effective group(95 cases)and ineffective group(36 cases).The copy quantity of EBV-DNA in the effective group before and after treatment was significantly lower than that in the ineffective group,while the ratio of copy quantity before and after treatment was significantly higher than that in the ineffective group,the differences were statistically significant(P<0.05).The proportion of radiotherapy in the effective group was significantly higher than that in the ineffective group,and the age was significantly lower than that in the ineffective group,the differences were statistically significant(P<0.05).The level of lactate dehydrogenase(LDH)and the maximum diameter of the largest lesion in the effective group were smaller than those in the ineffective group,and the differences were s

关 键 词：晚期鼻咽癌 标准化疗方案 EB病毒DNA水平 疗效预测 

分 类 号：R739.63[医药卫生—肿瘤]