外周血EBV-DNA和LDH水平在局部晚期鼻咽癌患者诱导化疗疗效评估的价值  

Peripheral blood EBV-DNA and LDH level as prognostic biomarkers in locally advanced nasopharyngeal carcinoma patients undergoing induction chemotherapy

作　　者：徐健 王文杰 程纪云 XuJian;Wang Wenjie;Cheng Jiyun(Department of Ophthalmology and Otorhinolaryngology,The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou,Jiangsu 215001,China)

机构地区：[1]苏州市立医院/南京医科大学附属苏州医院,江苏苏州215009

出　　处：《中国医学文摘（耳鼻咽喉科学）》2024年第2期46-50,F0002,共6页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：目的 探究诱导化疗后外周血EBV-DNA、LDH水平对接受诱导化疗的局部晚期鼻咽癌患者预后的评估价值。方法 选取2016年1月-2019年5月苏州市立医院收治的病理确诊为接受诱导化疗的局部晚期鼻咽癌患者40例。根据患者外周血EBV-DNA、LDH水平分别分为高组和低组,采用χ^(2)检验评估EBV-DNA、LDH水平与局部晚期鼻咽癌患者诱导化疗的疗效及预后是否存在相关性。通过Logistic回归分析评估EBV-DNA与LDH是否存在相关性。结果 外周血EBV-DNA≤423.8copies/ml的局部晚期鼻咽癌患者ORR(85%)远高于EBV-DNA>423.8copies/ml组的45%,两者差异具有统计学意义(p=0.02)。LDH≤163.5U/L组ORR为80%(16/20),LDH> 163.5U/L组ORR为50%(10/20),两者差异无统计学意义(p=0.097)。EBV-DNA≤423.8copies/ml且LDH≤163.5U/L组ORR为90%,远高于EBV-DNA≤423.8copies/ml且LDH> 163.5U/L组的20%,两者差异具有统计学意义(p=0.007)。回归分析显示EBV-DNA与LDH之间呈正相关关系。结论 诱导化疗后血浆EBV-DNA水平、EBV-DNA联合LDH对局部晚期鼻咽癌患者诱导化疗疗效评估具有一定价值。Background Nasopharyngeal carcinoma(NPC)is relatively uncommon but invasive.Plasma EBV-DNA and LDH are demonstrated to be correlated with the outcome of NPC.In the present study,we aimed to investigate the prognostic value of EBV-DNA and LDH in locally advanced NPC undergoing induction chemotherapy.Methods In total,40 locally advanced NPC patients undergoing induction chemotherapy were recruited in the study.The patients were divided into four groups according to EBV-DNA and LDH level.Betweengroup variations were performed by the x 2 tests.The correlation analysis was assessed by linear regression analysis to investigate the correlation between EBV-DNA and LDH.Results The objective response rate(ORR)of patients with higher plasma EBV-DNA level(>423.8copies/ml)was worse than that of lower EBV-DNA level(≤423.8copies/ml)(p=0.02).The difference between the ORR of patients with higher LDH level(>163.5U/L)and that of lower LDH level(≤163.5U/L)had no statistical significance(p=0.097).The ORR of patients with higher EBV-DNA level(>423.8copies/ml)combined with higher LDH level(>163.5U/L)was worse than that of lower EBV-DNA level(≤423.8copies/ml)combined with lower LDH level(≤163.5U/L)(p=0.007).Regression analysis showed positive correlation between EBV-DNA and LDH(R=0.529).Conclusion Higher post-treatment EBVDNA,as well as high post-treatment EBV-DNA combined with higher LDH,was correlated with worse outcome in locally advanced NPC patients undergoing induction chemotherapy.

关 键 词：局部晚期鼻咽癌 EBV-DNA LDH 预后 

分 类 号：R73[医药卫生—肿瘤]