血浆EBV-DNA水平对鼻咽癌患者预后价值的Meta分析  

The Prognostic Value of Plasma Epstein-Barr Virus DNA Load in Patients with Nasopharyngeal Carcinoma WhoReceived Radiotherapy:a Meta-analysis

作　　者：德丽达·库拉别克 郑侠 钱军[1] Delida Kulabieke;Zheng Xia;Qian Jun(Oncology Department of Afiliated Hospital of Nanjing University of Chinese Medicine,210000,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210000

出　　处：《中国医学文摘(耳鼻咽喉科学)》2025年第1期160-164,共5页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：目的本研究旨在评估血浆EBV-DNA水平对放疗后鼻咽癌患者的预测价值。方法在PubMed、Embase、Web of science和Cochrane等数据库中检索并筛选EBV-DNA与鼻咽癌患者放疗后生存结局相关性的全部研究,对纳入的研究进行Meta分析,研究终点为总生存期(overall survival,OS)、无进展生存期(progression-free survival,PFS)局部无复发生存期(local recurrence-free survival,LRFS)和无转移生存期(distant metastasis-free survival,DMFS),以风险比值(Hazard risk,HR)和95%置信区间(confidence interval,CI)作为合并效应量。通过漏斗图对称性、Egger和Bagg检验评估发表偏倚。结果本研究筛选出14项试验,纳入7896例接受放疗的鼻咽癌患者,经荟萃分析后发现,放疗前血浆EBV-DNA高是患者OS(HR=1.74,95%CI:1.46~2.09,P=0.000)、PFS(HR=1.60,95%CI:1.40~1.83,P=0.000),LRFS(HR=2.09,95%CI:1.30~3.35,P=0.000)和DMFS(HR=1.55,95%CI:1.03~2.19)的不良预后因子。且结果发表偏倚风险较小,具有较好的可靠性。结论血浆EBV-DNA可作为放疗后鼻咽癌患者疾病复发和生存结局的可靠生物标记物,值得临床广泛应用。Objective This study aimed to assess the prognostic value of EBV-DNA loads in patients with nasopharyngeal cancer after radiation therapy.Methods Identifying the search focusing on the pre-treatment EBV-DNA levels and post-radiotherapy NPC patents'clinical outcomes.Source included PubMed,Embase,web of science and Cochrane Library databases.The primary endpoints included overall survival(OS),progression-free survival(PFS),local recurrence-free survival(LRFS)and distant metastasis-free survival(DMFS).The pooled analysis of hazard risks(HRs)and 95%confidence intervals(CIs)for the outcomes above were performed.Publication bias was examined by the funnel plot,egger's test and bagg's test.Results 14 studies with 7896 postradiotherapy nasopharyngeal cancer patients were eligible.We found that high level of pre-EBV-DNA was associated with worse OS(HR=1.74,95%CI:1.46~2.09,P=0.000),PFS(HR=1.60,95%CI:1.40~1.83,P=0.000),LRFS(HR=2.09,95%CI:1.30~3.35,P=0.000)andDMFS(HR=1.55,95%CI:1.03~2.19),respectively.Sensitivity analysis showed stable results of the above pooled analysis.There were no significant publication biases in this study.Conclusion This Meta-analysis supported that higher pretreatment EBV-DNA load followed with unsatisfied outcomes.EBV-DNA load could be considered and applied as a biomarker for predicting nasopharyngeal cancer patients survival and disease relapse risk.

关 键 词：鼻咽癌 放疗 EBV-DNA 预后 荟萃分析 

分 类 号：R73[医药卫生—肿瘤]