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

Clinical application of plasma cell-free EBV DNA,serum CYFRA21-1 and VCA-IgA in patients with nasopharyngeal carcinoma

目的:探讨血浆EB病毒DNA、血清细胞角蛋白19片段(CYFRA21-1)和EB病毒壳抗原IgA(VCA-IgA)三种肿瘤标记物对鼻咽癌诊断、疗效监测和预后判断的临床应用价值。方法:分别采用荧光定量PCR法、电化学发光法和免疫酶法检测62例鼻咽癌患者治疗前、后及62例健康对照者血浆EBV DNA、血清CY-FRA21-1和VCA-IgA含量,并进行对比分析。结果:治疗前血浆EBV DNA、血清CYFRA21-1和VCA-IgA的阳性率明显高于健康对照组(P<0.01);治疗后血浆EBV DNA、血清CYFRA21-1和VCA-IgA含量高者,在随访中发现肿瘤残存、复发或远处转移。结论:血浆EBV DNA、血清CYFRA21-1和VCA-IgA的检测对鼻咽癌早期诊断、高危人群筛查、以疗效监测和预后判断有重要临床应用价值,三种肿瘤标记物联合检测有互补作用。

Objective：To investigate the role of plasma EBV DNA,serum CYFRA21-1 and VCA-IgA in diagnosis,curative effect survey and prognosis of nasopharyngeal carcinoma patients（NPC）.Methods： Plasma EBV DNA,serum CYFRA21-1 and VCA-IgA in 62 nasopharyngeal carcinoma patients and 62 healthy controls were analyzed using fluorescence quantitative polymerase chain reaction,electrochemiluminescence immunoassay,and immunoenzyme assay,respectively.Results： The positive rates and concentrations of plasma EBV DNA,serum CYFRA21-1 and VCA-IgA among new cases with NPC were significantly higher than those of healthy controls（P〈0.01）.After treatment,patients had significantly higher plasma EBV DNA and serum VCA-IgA concentration compared with patients who had not,the residual tumors,locoregional recurrence and distant metastasis.Conclusion： plasma EBV DNA,serum CYFRA21-1 and VCA-IgA detectin have important value in early diagnosis,screening of high risk population,curative effect survey and prognosis.