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[目的]探讨血浆EBV-DNA定量分析用于NPC患者放疗预后评估的价值。[方法]选取50例初诊NPC患者为研究对象,50例健康者为健康对照组,20例头颈部其他癌瘤患者为病例对照组。采用实时荧光定量PCR检测血浆EBV-DNA,并对放疗后NPC患者进行随访。对所得数据进行统计学分析。[结果]NPC患者中EB病毒游离DNA的阳性率为84.0%(42/50),健康对照人群中阳性率为10.0%(5/50),其他头颈部肿瘤患者全部阴性(0/20),NPC患者与其他各组间EB病毒DNA的阳性率差异有统计学意义(P﹤0.01)。NPC病人治疗前血浆EBV-DNA检出率显著高于治疗后(P﹤0.001)和健康人(P﹤0.001)。NPC病人治疗后血浆EBV-DNA水平和检出率与健康人差异均无统计学意义(P=0.243;P=0.262)。放疗后随访发现,12例患者血浆EBV-DNA阳性,其中有8例在随后的6个月随访中分别出现复发或转移(5例局部复发,2例肺转移,1例骨转移),38例未检测出血浆EBV-DNA阳性者,在随后的6个月随访中有7出现复发或转移。[结论]血浆EBV-DNA在NPC患者中高表达,同时也是NPC放疗后监测复发和转移的可靠指标。
[Objective] To investigate the value of plasma EBV-DNA quantitative analysis in the prognosis evaluation of patients with NPC. [Methods] Fifty newly diagnosed NPC patients were selected as study subjects, 50 healthy controls were healthy controls, and 20 other patients with head and neck cancer were selected as case control group. Plasma EBV-DNA was detected by real-time fluorescence quantitative PCR, and NPC patients were followed up after radiotherapy. The data obtained for statistical analysis. [Results] The positive rate of Epstein-Barr virus DNA was 84.0% (42/50) in NPC patients and 10.0% (5/50) in healthy controls. All the other head and neck cancer patients were negative (0/20) There were significant differences in the positive rates of Epstein-Barr virus DNA between NPC patients and other groups (P <0.01). The detection rate of plasma EBV-DNA in NPC patients before treatment was significantly higher than that after treatment (P <0.001) and healthy people (P <0.001). Plasma EBV-DNA levels and the detection rate of NPC patients after treatment were not significantly different from healthy people (P = 0.243; P = 0.262). Follow-up after radiotherapy found that plasma EBV-DNA positive in 12 patients, of which 8 cases were followed up in the follow-up of 6 months were relapse or metastasis (5 cases of local recurrence, 2 cases of lung metastases, 1 case of bone metastases), 38 cases No positive plasma EBV-DNA was detected in 7 of the 6 follow-up visits in the subsequent recurrence or metastasis. [Conclusion] Plasma EBV-DNA is highly expressed in NPC patients and is also a reliable indicator of recurrence and metastasis after NPC radiotherapy.