鼻咽癌患者血浆EB病毒DNA水平的动态变化与临床疗效的关系

Correlation between the Kinetics of Plasma EBV DNA Levels and Clinical Response During Treatment In Patien ts with Nasopharyngeal Carcinoma

背景与目的:鼻咽癌是一种与EB病毒相关的肿瘤。最近,一些学者报道了鼻咽癌患者血浆或血清中可检测到EB病毒DNA。本研究观察晚期鼻咽癌患者同期放化疗中血浆EB病毒DNA水平的动态变化以及与临床疗效的关系。方法:20例初治患者在同期放化疗期间每周抽血一次,共7次,第一次抽血时间为治疗前。所有的标本均采用荧光定量PCR的方法,在PE7700型检测仪上定量检测血浆标本中EB病毒DNA的含量。结果:90%(18/20)患者治疗前的血浆中可检测到EB病毒DNA,中位浓度为150000copies/ml。2例患者自治疗开始至结束血浆中均未检测到EB病毒DNA。18例阳性患者中,3例患者在治疗期间可检测到持续高水平的EB病毒DNA,治疗后临床结果显示三者均有肿瘤残留。7例患者EB病毒DNA水平在治疗开始后迅速下降至检测不到;8例患者血浆EB病毒DNA水平下降缓慢,但在治疗结束时,EB病毒DNA均检测不到。临床结果显示,此15例患者均达到完全缓解。结论:血浆EB病毒DNA水平的变化与鼻咽癌患者临床疗效关系密切,值得进一步研究。

Background &Objective:Nasopharyngeal carcinoma (NPC)is an EB virus(EBV)related cancer.Recently,it was reported that EBV DN A can be detected in NPC patients' plasma or serum.This study was desig ned to investigate the correlation between the kinetics of plasma EBV DNA levels and clinical response during concomitant chemo-radiotherapy in the locally a dvanced nasopharyngeal carcinoma p atients.Methods:Blood samples from 20patients were collected weekly during chemo-radiotherapy(7times,in total).The first blood sample was collecte d before treatment.The content of EBV DNA in the samples were detected by using fluorescent quantitative PCR method in the PE Appli ance Biosystems 7700Sequence Detector.Results:Before treatment,plasma EBV DNA was detectable in the plasma of 90%(18/20)NPC patients.The median concentration was 150000(copies /ml ).Two patients' plasma EBV DNA could not be detected during the whole course of t reatment.Among 18EBV DNA-positive patients,3patien ts had a continuously high EBV DNA and clinical examinatio n after treatment indicated that they had residual tum ors.Seven patients'plasma EBV DNA levels had a rapid decline to b e undetectable.Eight patientsplasma EBV DNA levels got a slow decline,but the EBV DNA could not be detected at the end of therapy as well.Clinical examination revealed that all of these 15patients had complete tumor regression.Conclussion:Kinetic analysis of plasma EBV DNA during treatment may b e a useful tool to monitor the treatme nt response in NPC patients.Further investigation is warranted.