血浆EBV-DNA联合窄带成像技术在鼻咽癌复发监测中的应用价值  

Application value of plasma EBV-DNA combined with narrow-band imaging technology in the monitoring of nasopharyngeal carcinoma recurrence

作　　者：覃丽玲[1] 孔令平[1] 林贤俊[1] 赵海云[1] 林高娟[2] 莫规兴 QIN Liling;KONG Lingping;LIN Xianjun;ZHAO Haiyun;LIN Gaojuan;MO Guixing(Department of Otolaryngology,Nanxishan Hospital of Guangxi Zhuang Autonomous Regio,Guilin 541002,China;Department of Head and Neck Oncology,Nanxishan Hospital of Guangxi Zhuang Autonomous Regio,Guilin 541002,China)

机构地区：[1]广西壮族自治区南溪山医院耳鼻咽喉头颈外科,桂林541002 [2]广西壮族自治区南溪山医院头颈肿瘤科,桂林541002

出　　处：《华夏医学》2024年第3期131-137,共7页Acta Medicinae Sinica

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190301)。

摘　　要：目的探讨血浆EB病毒DNA(EBV-DNA)联合窄带成像技术(NBI)在鼻咽癌(NPC)复发监测中的应用价值。方法选取NPC复发患者86例和未复发患者142例为研究对象,观察EBVDNA、NBI、EBV-DNA联合NBI方法在NPC复发诊断中的灵敏度、特异度、阳性预测值、阴性预测值、一致性检验(Kappa值);采用受试者工作特征曲线(ROC)分析EBV-DNA、NBI、EBV-DNA联合NBI诊断NPC复发的曲线下面积(AUC)。结果ROC分析结果显示,EBV-DNA、NBI、EBV-DNA联合NBI诊断NPC复发的AUC分别为0.826、0.845、0.893,EBV-DNA联合NBI预测复发的AUC比单一方法检测大,差异具有统计学意义(P<0.05)。分层分析结果显示,预测早期患者NPC复发和晚期NPC复发的AUC为0.924和0.865,Kappa值为0.827和0.696。结论在监测NPC复发诊断中,EBV-DNA联合NBI方法比单一方法效能高,在临床分期为早期的NPC患者中效果更佳,值得临床上应用推广。Objective To explore the application value of plasma epstein barr-virus DNA(EBV-DNA)combined with narrow-band imaging(NBI)in monitoring the recurrence of nasopharyngeal carcinoma(NPC).Methods 86 patients with recurrent NPC and 142 patients without recurrence were enrolled.The sensitivity,specificity,positive predictive value,negative predictive value,and consistency test(Kappa value)of EBV-DNA,NBI,and EBV-DNA combined with NBI method in the diagnosis of NPC recurrence were observed.Receiver operating characteristic curve(ROC)was used to analyze the area under the curve(AUC)of EBV-DNA,NBI,and EBV-DNA combined with NBI for diagnosing NPC recurrence.Results ROC curve analysis results showed that the AUC of plasma EBV-DNA,NBI and combined diagnosis of NPC recurrence were 0.826,0.845 and 0.893,respectively,and the AUC of plasma EBV-DNA combined with NBI was greater in predicting recurrence,with a statistically significance difference(P<0.05).The stratified analysis showed that the AUC for predicting the recurrence of NPC in early and late patients was 0.924 and 0.865,and the Kappa value was 0.827 and 0.696.Conclusion In monitoring the diagnosis of NPC recurrence,the EBV-DNA combined with NBI method is more effective than a single method and is more effective in early-stage NPC patients.It is worthy of clinical application and promotion.

关 键 词：鼻咽癌 复发监测 窄带成像技术 EB病毒DNA 

分 类 号：R739.63[医药卫生—肿瘤]