血清EB病毒抗体水平与鼻咽癌患者预后的关系

Prognostic significance of serum anti-Epstein-Barr virus antibodies in nasopharyngeal carcinoma

目的探讨血清EB病毒VCA／IgA、EA／IgA、NA1／IgA及Rta／IgG抗体水平与鼻咽癌患者预后的关系。方法140例初治无远处转移的鼻咽癌患者分别在治疗前和治疗结束后采用免疫酶法检测血清VCA／IgA和EA／IgA，ELISA法检测NAl／IgA和Rta／IgG。随访进行远期疗效和生存的评价。结果治疗后患者血清VCA／IgA、EA／IgA、NA1／IgA及Rta／IgG抗体水平较治疗前有明显下降，但仍显著高于正常对照组（P〈0．05）。治疗后持续缓解的鼻咽癌患者其治疗前VCA／IgA、EA／IgA抗体水平显著低于疾病进展患者（P〈0．05）。血清VCA／IgA、EA／IgA、NA1／IgA及Rta／IgG抗体水平与患者的3年总生存率无关（P〉0．05）。治疗前VCA／IgA抗体高水平组（≥1：320）及EA／IgA抗体高水平组（≥1：80）患者的无进展生存期（61．8％，61．3％）低于抗体低水平组患者（86．5％，86．5％；P〈0．001）。Cox回归分析显示治疗前VCA／IgA抗体水平是影响无进展生存的独立危险因素（HR=3．80，P=0．001）。结论VCA／IgA、EA／IgA可为鼻咽癌患者预后判断提供帮助。

Objective This study was aimed to investigate the association between serum against Epstein-Barr virus （EBV） antibodies levels and nasopharyngeal carcinoma （NPC） patients＇ prognosis. Methods Blood samples from 140 primary NPC patients without metastasis were collected before and after treatment. The titers of VCA/IgA and EA/IgA were detected by immunoenzyme assay, and the levels of NAI/IgA and Rta/IgG were detected by enzyme-linked immunosorbent assay （ELISA）. All patients received consequent follow-up and long-term efficacy and survival assessment. Results Post-treatment serum levels of VCA/IgA, EA/IgA, NA1/IgA and Rta/IgG in NPC patients significantly decreased than those before treatment, while had significantly higher than those in control individuals （P 〈 0. 05）. Patients in remission had significantly lower pre-treatment serum levels of VCA/IgA and EA/IgA than patients with progression （P 〈 0.05）. None of serum levels of VCA/IgA, EA/IgA, NA1/IgA and Rta/IgG was associated with the 3-year overall survival （P 〉 0. 05）. The progression-free survivals were significantly lower in patients with higher pre-treatment VCA/IgA （ ≥ 1：320） and EA/IgA （≥ 1 ： 80） levels than in those with lower VCA/IgA （ 〈 1： 320） and EA/IgA （ 〈 1： 80） levels, respectively （61.8% vs. 86. 5% , 61.3% vs. 86. 5% , P 〈 0. 001 ）. Cox regression model analysis demonstrated that pre-treatment serum VCA/IgA level was an independent risk factor for progression-free survival （HR = 3.80, P = 0. 001 ）. Conclusion Anti-EBV VCA/IgA and EA/IgA might provide information regarding the prognosis of NPC patients.