EBV DNA定量分析在监测鼻咽癌转移和复发中的临床意义

背景与目的:EB病毒(Epstein-Barrvirus,EBV)感染与鼻咽癌关系密切,近年来,有报道鼻咽癌患者血浆/血清中可检测到游离EBVDNA,但血浆EBVDNA水平对判断放疗后鼻咽癌患者转移、复发的临床意义尚缺少大宗研究报道。本研究定量检测鼻咽癌放疗后随诊患者血浆EBVDNA含量,探讨其在监测鼻咽癌转移、复发中的临床意义。方法:选择在中山大学肿瘤防治中心门诊随诊的放疗后鼻咽癌患者90例,用荧光定量PCR方法检测血浆EBVDNA含量,比较转移、复发与持续缓解患者血浆EBVDNA拷贝数。结果:放疗后转移或复发患者血浆EBVDNA的检出率为96.7%(29/30),中位拷贝数为2650copies/ml(0～5900000copies/ml);而持续缓解组患者血浆EBVDNA检出率12%(7/60),中位拷贝数为0copy/ml(0～71000copies/ml),差异均有统计学意义(P<0.01)。3例临床持续缓解但有血浆EBVDNA升高患者,在随后的3～4个月随访中,证实有肿瘤转移或复发。结论:血浆EBVDNA李宇红,等.EBVDNA定量分析在646定量检测可能成为监测放疗后鼻咽癌患者肿瘤转移、复发的敏感肿瘤标记物。

Quantitative analysis of plasma Epstein-Barr virus (EBV) DNA for monitoring of recurrence and metastasis in nasopharyngeal carcinoma patients after radiotherapy

BACKGROUND &OBJECTIVE:Nasopharyng eal carcinoma (NPC)is closely related to Epstein-Barr v irus (EBV)infection.Recently,it was reported that EBV DNA could be detect ed in the plasma or serum of NPC patients ,but the clinical sig nific ance of EBV DNA concentration for monitoring of tumor recurrence and metastasis in NPC patients after radiotherapy has n ot been reported.This study was desig ned to quantitatively analyze the plasma E BV DNA concentration in NPC patients after radiotherapy,and to evaluate its ap plication for monitoring of tumor recurrence a nd metastasis.METHODS :Ninety NPC outpatients after radiotherapy in C ancer Center,Sun Yat-sen Universit y were followed up.The plasma EBV DNA were a nalyzed by using fluorescent quantitative PCR technique,and the quantity of plasma EBV DNA were compared between recurrent and clin ical remission NPC patients.RESULTS :Ninety-six point seven percent (29/30)of recurrent and metastatic patient s were detectable for plasma EBV DNA,with median concentration of 2650copies /ml (rang e:0-5900000),whereas only 12%(7/60)of the clinical remission patients were detectable for plasma EBV DNA,w ith median concentration of 0copy /m l(rang e:0-71000).The detectable proportion and conc entration in recurrent and metastatic NPC patients were sig nif icantly hig her than that in clinical remission NPC patients(P<0.01).Three of the clinical remission NPC patients with elevated EBV DNA copy were confirmed for tumor local recurrence or metast asis after further 3-4month follow-up.CONCLUSION:The results sug g est that plasma EBV DNA detection may be a sensitive t umor marker for monitoring tumor recurrence and metastasis of NPC pat ients after radiotherapy.