EB病毒感染与结直肠癌病理特征及化疗近期预后的相关性分析  

Correlation of Epstein-Barr virus infection with pathological characteristics of colorectal cancer and its short-term prognosisr after chemotherapy

作　　者：丁颖威 陈钢[1] 华宏军[1] 卢翀 Ying-Wei Ding;Gang Chen;Hong-Jun Hua;Chong Lu(Department of Emergency Medicine,Jinhua Municipal Central Hospital,Jinhua 321000,Zhejiang Province,China)

机构地区：[1]金华市中心医院急诊科,浙江省金华市321000

出　　处：《世界华人消化杂志》2025年第4期316-323,共8页World Chinese Journal of Digestology

基　　金：金华市科技计划项目,No.2022-4110.

摘　　要：背景近年来有研究指出EB病毒(Epstein-Barr virus,EBV)可能在结直肠癌中发挥作用.现阶段,临床关于EBV参与肿瘤细胞增殖、分化、迁移的报道主要集中在胃癌、鼻咽癌、B细胞淋巴瘤等肿瘤疾病,其具有促进肿瘤发展、调控机体免疫微环境等作用,EBV与结直肠癌的关系尚不确切.目的分析EBV感染与结直肠癌病理特征及化疗近期预后的相关性,为临床诊治、预后评估提供参考.方法选取2021-05/2024-03金华市中心医院收治的45例EBV阳性结直肠癌患者为EBV阳性组,另选取同期180例EBV阴性结直肠癌患者为EBV阴性组,分析EBV感染与结直肠癌临床病理特征的关系,比较EBV阳性组不同病理特征患者的EBV-DNA载量,分析EBV-DNA载量与结直肠癌病理特征的相关性;统计结直肠癌患者近期预后,比较不同近期预后患者病理特征及EBV感染情况,分析影响患者近期预后的因素,分析EBV感染、病理特征对结直肠癌患者近期预后的预测价值.结果EBV阳性组肿瘤分期Ⅲ期+Ⅳ期、低分化、浸润深度T3期+T4期、有淋巴结转移占比高于EBV阴性组(P<0.05);EBV阳性组不同分化程度、浸润深度、肿瘤分期、淋巴结转移患者EBV-DNA载量比较差异有统计学意义(P<0.05);EBV感染结直肠癌患者的EBV-DNA载量与分化程度呈负相关,与肿瘤分期、淋巴结转移、浸润深度呈正相关(P<0.05);淋巴结转移、分化程度、肿瘤分期、浸润深度、EBV均为结直肠癌患者近期预后的独立影响因素(P<0.05);肿瘤分期、浸润深度、淋巴结转移、分化程度、EBV联合预测结直肠癌患者近期预后的曲线下面积为0.882(95%CI:0.832-0.921),敏感度为84.93%、特异度为91.45%(P<0.05).结论EBV感染与结直肠癌肿瘤分期、分化程度、浸润深度、淋巴结转移及化疗近期预后有明显相关性,联合病理特征及EBV阳性检测对结直肠癌患者近期预后有较高预测价值.BACKGROUND In recent years,studies have demonstrated that Epstein-Barr virus(EBV)may play a role in the occurrence of colorectal cancer.Currently,clinical reports on EBV involved in tumor cell proliferation,differentiation,and migration are mainly concentrated in gastric cancer,nasopharyngeal carcinoma,B-cell lymphoma,etc.,which have the functions of promoting tumor development and regulating the body’s immune microenvironment.The relationship between EBV and colorectal cancer has been less explored.AIM To analyze the correlation between EBV infection and the pathological characteristics of colorectal cancer as well as its short-term prognosis after chemotherapy to provide reference for its clinical diagnosis,treatment,and prognosis evaluation.METHODS A total of 45 EBV-positive and 180 EBV-negative colorectal cancer patients admitted to Jinhua Central Hospital from May 2021 to March 2024 were selected.The relationship between EBV infection and the clinicopathological characteristics of colorectal cancer was analyzed,and the EBV-DNA load was compared in patients with different pathological characteristics in the EBV-positive group.The correlation between EBV-DNA load and pathological characteristics of colorectal cancer was analyzed.The short-term prognosis of colorectal cancer patients after chemotherapy was recorded.The pathological characteristics and EBV infection status was compared in patients with different short-term prognoses.The factors that affect the patients’short-term prognosis were analyzed.The predictive value of EBV infection and pathological characteristics for the short-term prognosis of colorectal cancer patients was analyzed.RESULTS The proportions of patients with stageⅢ+Ⅳ,low differentiation,deep invasion(T3+T4),and lymph node metastasis in the EBV-positive group were higher than those of the EBV-negative group(P<0.05).EBV-DNA load differed significantly in patients with different degrees of differentiation,infiltration depth,tumor stages,and lymph node metastasis in the EBV-positive

关 键 词：结直肠癌 化疗 EB病毒 EBV-DNA载量 淋巴结转移 

分 类 号：R735.3[医药卫生—肿瘤]