CAJ | 학술논문

目的探讨EBV-DNA定量检测对于局部晚期鼻咽癌肿瘤患者进行放化疗治疗后疗效及随访中出现肿瘤复发转移进行诊断的意义.方法采用荧光定量PCR技术对173例经诊断为局部晚期鼻咽癌患者的放化疗联合治疗前及治疗0、2、4、6、8周的血浆EBV-DNA水平进行检测,同时对156例治疗前血浆EBV-DNA检测为阳性的患者进行治疗后6、12、18、24个月的血浆EBV-DNA进行检测并对其肿瘤复发转移情况进行统计.分析血浆EBV-DNA水平与患者治疗效果及治疗后2年随访出现肿瘤复发的相关性.结果 173例患者的血浆EBV-DNA检出阳性为156例,阳性检出率达90.2％,并且8周血浆EBV-DNA检出阳性率较之出现显著降低(P＜0.001).另外,对完全缓解组及部分缓解组患者的8周血浆EBV-DNA检出阳性率进行比较,结果表明完全缓解组患者8周血浆EBV-DNA检出阳性率明显降低(P ＜0.001).对143例治疗前血浆EBV-DNA阳性的患者随访情况分析表明,1、2年血浆EBV-DNA检测水平分别对患者1、2年复发转移的诊断灵敏度及特异性较高,ROC曲线Az分别为0.964、0.892(P ＜0.001).结论血浆EBV-DNA定量检测能够较好反映局部鼻咽癌晚期患者的放化疗疗效并且其在患者2年随访出现肿瘤复发转移中具有较高的诊断价值.
목적 탐토EBV-DNA정량검측대우국부만기비인암종류환자진행방화료치료후료효급수방중출현종류복발전이진행진단적의의.방법 채용형광정량PCR기술대173례경진단위국부만기비인암환자적방화료연합치료전급치료0、2、4、6、8주적혈장EBV-DNA수평진행검측,동시대156례치료전혈장EBV-DNA검측위양성적환자진행치료후6、12、18、24개월적혈장EBV-DNA진행검측병대기종류복발전이정황진행통계.분석혈장EBV-DNA수평여환자치료효과급치료후2년수방출현종류복발적상관성.결과 173례환자적혈장EBV-DNA검출양성위156례,양성검출솔체90.2％,병차8주혈장EBV-DNA검출양성솔교지출현현저강저(P＜0.001).령외,대완전완해조급부분완해조환자적8주혈장EBV-DNA검출양성솔진행비교,결과표명완전완해조환자8주혈장EBV-DNA검출양성솔명현강저(P ＜0.001).대143례치료전혈장EBV-DNA양성적환자수방정황분석표명,1、2년혈장EBV-DNA검측수평분별대환자1、2년복발전이적진단령민도급특이성교고,ROC곡선Az분별위0.964、0.892(P ＜0.001).결론 혈장EBV-DNA정량검측능구교호반영국부비인암만기환자적방화료료효병차기재환자2년수방출현종류복발전이중구유교고적진단개치.
Objective To explore the clinical value of EBV-DNA quantitative detection in treatment and follow-up of metastasis and recurrence of cancer in patients with locally advanced nasopharyngeal carcinoma.Methods Quantitative real-time PCR was used to detect plasma EBV-DNA in 173 cases of patients before and 0,2,4,6 and 8 weeks after the radiochemotherapy treatment,and also used to detect plasma EBV-DNA at 6,12,18 and 24 months after the treatment in 156 cases of patients whose EBV-DNA was positive before treatment.The clinical effect of plasma EBV-DNA level in assessment of effect of treatment and cancer' s metastasis and recurrence during 2 years' of follow-up was analyzed.Results The positive rate of the 156 cases of patients was 90.2％ and the positive rate of plasma EBV-DNA significantly decreased at 8 weeks after treatment (P ＜ 0.001).Plasma EBV-DNA level of patients in complete-response group is significantly lower than that of partial-response group at 8 weeks after the treatment (P ＜ 0.001).The follow-up results of 143 positive cases of patients before treatment shows that 1 or 2-year plasma EBV-DNA levels were higher judged on specificity and sensitivity of 1 or 2-year recurrence rate of nasopharyngeal carcinoma (Az =0.964、0.892;P ＜0.001).Conclusions Plasma EBV-DNA quantitative detection can reflect the effect of radiochemotherapy treatment and recurrence of carcinoma in patients with locally advanced nasopharyngeal carcinoma.