鼻咽癌患者血浆EBV-DNA、血清CYFRA21-1、TSGF的检测及临床应用

Quantification and clinical application of plasma cell-free EBV-DNA,serum CYFRA21-1 and TSGF in patients with nasopharyngeal carcinoma

目的:探讨和比较血浆EBV-DNA、血清CYFRA21-1、TSGF在鼻咽癌诊断、近期疗效判断及监测复发和转移等方面的临床意义。方法:分别采用荧光定量PCR、电化学发光免疫测定法及比色法检测46例鼻咽癌患者及15例健康对照的血浆EBV-DNA、血清CYFRA21-1及TSGF。结果:初诊患者血浆EBV-DNA、血清CYFRA21-1、TSGF检测的阳性率及浓度均明显高于健康对照组(P<0.05),其中血浆EBV-DNA检测的敏感性最高95.2%(20/21)。治疗后有肿瘤残余的患者血浆EBV-DNA及血清TSGF浓度明显高于肿瘤完全消退的患者(P<0.05)。局部复发和远处转移的患者三种指标阳性率及浓度均明显高于持续缓解患者(P<0.05)。结论:血浆EBV-DNA、血清CYFRA21-1及TSGF的检测对鼻咽癌的诊断、近期疗效判断及监测局部复发或远处转移都有重要价值,其中血浆EBV-DNA检测的作用更佳。

Objective：To investigate and to compare the roles of plasma EBV -DNA, serum CYFRA21 -1, TSGF in diagnosis, evaluation of therapeutic response and monitoring of locoregional recurrence or distant metastasis of nasopharyngeal caxcinoma（NPC） patients. Methods： The plasma EBV -DNA, serum CYFRA21 -1 and TSGF in 46 NPC patients and 15 healthy controls were analyzed using fluorescence quantitative polymerase chain reaction, electro- chemi- luminescence immuno- assay, spectro- photometry, respectively. Results： The positive rates and concentrations of plasma EBV - DNA, serum CYFRA21 - 1 and TSGF among new cases with NPC were significantly higher than those among healthy controls （P 〈 0.05 ）. The sensitivity of plasma EBV - DNA assay （95.2%, 20/21 ） was the highest. After the completion of treatment, the patients who had residual tumors had significantly higher plasma EBV - DNA and serum TSGF concentration compared with patients who had not （ P 〈 0.05 ）. The positive rates and concentrations of these three markers among patients with locoregional recurrence and distant metastasis were significantly higher compared with those of patients in clinical remission （P 〈 0. 05）. Conclusion： Plasma EBV - DNA, serum CYFRA21 - 1 and TSGF detection have important value in diagnosis, evaluation of therapeutic response and monitoring of locoregional recurrence or distant metastasis, furthermore, plasma EBV - DNA detection is a better method compared with others.