合并干燥综合征、脑脊液EBV阳性的初发鼻咽癌1例并文献复习  

Primary nasopharyngeal carcinoma with Sjögren′s syndrome and positive cerebrospinal fluid Epstein-Barr virus:a case report and literature review

作　　者：王爽[1] 邱峰 张红丽[1] 赵珺 冯锦丽[1] Wang Shuang;Qiu Feng;Zhang Hongli;Zhao Jun;Feng Jinli(Department of Neurology,Eighth Medical Center,General Hospital of the People′s Liberation Army,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心神经内科,北京100091

出　　处：《中华内科杂志》2024年第5期490-494,共5页Chinese Journal of Internal Medicine

摘　　要：通过回顾2021年3月3日解放军总医院第八医学中心宏基因组学第二代测序技术(mNGS)检测到脑脊液EBV阳性合并干燥综合征的初发鼻咽癌患者1例的诊治过程,检索国内外数据库有关脑脊液EBV阳性的脑炎或脑膜炎、鼻咽癌相关报道,对所有患者的一般资料、首发症状、治疗及预后进行分析。脑脊液EBV阳性与自身免疫病、病毒性脑炎或脑膜炎、鼻咽癌相关,合并干燥综合征少见;脑脊液EBV阳性多在复发鼻咽癌患者中出现,初发鼻咽癌患者脑脊液EBV阳性鲜见报道。对于具有免疫背景、临床以头痛或颅神经受累为主要表现,或者疑诊鼻咽癌的患者,宜尽早行脑脊液mNGS或EBV DNA检测以评估危险分层,判断预后,制定个性化的治疗方案。The study presents an analysis of the diagnostic and treatment protocol for a patient with a first episode of nasopharyngeal carcinoma who also has Sjogren′s syndrome and Epstein-Barr Virus(EBV)positive cerebrospinal fluid,as detected through metagenomic next-generation sequencing(mNGS).It reviews existing literature to examine the connections between EBV and various conditions including Sjogren′s syndrome,encephalitis or meningitis,and nasopharyngeal carcinoma,emphasizing the importance of EBV positive cerebrospinal fluid.The study focuses on a case from the Eighth Medical Center of the General Hospital of the People′s Liberation Army,where a patient was admitted with headaches as the primary symptom on March 3,2021.This patient had a history of Sjogren′s syndrome and was later diagnosed with nasopharyngeal carcinoma.The research involved reviewing both domestic and international databases for cases related to cerebrospinal fluid EBV positive encephalitis or meningitis,and nasopharyngeal carcinoma.It aimed to aggregate data on demographics,initial symptoms,treatment methods,and patient outcomes.Findings suggest that positive cerebrospinal fluid EBV is linked to autoimmune diseases,viral encephalitis or meningitis,and nasopharyngeal carcinoma,albeit infrequently in the context of Sjogren′s syndrome.Notably,EBV positive cerebrospinal fluid is commonly associated with recurrent nasopharyngeal carcinoma rather than initial episodes.The study concludes that for patients with an immune condition,exhibiting symptoms like headaches or cranial nerve issues,or in cases where nasopharyngeal carcinoma is suspected,early testing through cerebrospinal fluid mNGS or EBV DNA is recommended.This approach facilitates risk assessment,prognosis determination,and the creation of individualized treatment plans.

关 键 词：干燥综合征 EB病毒脑炎 鼻咽癌 宏基因组二代测序 

分 类 号：R73[医药卫生—肿瘤]