PET-CT联合EBV-DNA在预测鼻咽癌复发中的研究

PET-CT and EBV-DNA in prediction of the recurrence of nasopharyngeal carcinoma

目的分析正电子发射断层显像/X线计算机体层成像仪(positron emission tomography/computedtomography,PET-CT)联合EB病毒(Epstein Barr-Virus,EBV),EBV-DNA在预测鼻咽癌复发中的临床价值。方法回顾性分析89例鼻咽癌患者随访资料,排除实验干扰因素,同期行EBV-DNA检测、PET-CT和MRI检查。PET-CT联合EBV-DNA为A组,单独PET-CT为B组,MRI为C组,对比分析各组检测结果,找出预测鼻咽癌复发的最佳方案。结果 A组预测鼻咽癌复发的准确率(97.8%)明显高于B组(89.9%)与C组(83.1%)。A组与B组准确率的差异有统计学意义(X^2=4.748,P<0.05),A组与C组差异有统计学意义(X^2=10,991,P<0.01),B组与C组差异无统计学意义(X^2=1.734,P>0.05)。PET-CT阳性检出率与EBV-DNA阳性检出率之间存在相关性,其相关程度明显高于PET-CT与MRI的相关性。结论血浆EBV-DNA筛查可作为检测鼻咽癌复发的敏感指标,PET-CT联合EBV-DNA检查有望成为预测鼻咽癌复发的优化方案。

OBJECTIVE To study the clinical significance of the PET-CT and EBV-DNA in prediction of the recurrence of nasopharyngeal carcinoma （NPC） . METHODS The EBV-DNA, PET-CT and MRI were taken in 89 patients with NPC during follow up. The combined examination of PET-CT and EBV-DNA was assumed as group A, PET-CT examination alone as group B and MRI alone as group C. The results of the different groups were analyzed to find the best method to prediction the recurrence of NPC. RESULTS The accuracy rate of the combination of PET-CT and EBV-DNA for prediction of the recurrence of NPC （97.8%） was better than that of PET-CT alone （89.9%） and MRI alone （83.1%） . There were significant difference between group A and B （χ2=4.748, P〈0.05） and group A and C （χ2=10.991, P〈0.01） . There was no statistics significance between group B and C （χ2=1.734, P〉0.05） . The positive rate of PET-CT and EBV-DNA titer levels exist relationship and the relationship is greater than the relationship of PET- CT and MRI. CONCLUSION EBV-DNA was a sensitive index in screening the recurrence NPC. The combination of PET-CT and EBV-DNA examination were the best method for prediction of the recurrence of NPC.