血浆EBV-DNA定量检测对复发/转移鼻咽癌患者的意义

The Significance of Quantitative Determination of Plasma EBVDNA in Recurrence/metastasis Nasopharyngeal Carcinoma Patients

[目的]探讨EBV-DNA在复发/转移鼻咽癌患者中表达特点及其临床意义。[方法]56例行EBV-DNA检测的复发/转移鼻咽癌患者56例,其中有25例患者为单纯局部复发,27例患者为单纯远处转移,4例患者为局部复发伴远处转移,另收集100例目前无复发证据的已治鼻咽癌患者作为对照。荧光定量PCR检测血浆EBV-DNA的表达水平。[结果]56例复发/转移鼻咽癌患者中血浆EBV-DNA阳性检出率为57.1%(32/56),阳性患者中EBVDNA中位浓度为3.845×103copies/ml。单纯局部复发患者中,EBV-DNA阳性检出率为56.0%(14/25),单纯远处转移的患者中,EBV-DNA阳性检出率为51.8%(14/27),局部复发伴转移的患者中,EBV-DNA阳性率为100.00%(4/4)。100例无复发证据的已治鼻咽癌患者中,EBVDNA阳性检出率为4.0%(4/100),阳性患者中EBV-DNA中位浓度为1.79×102copies/ml。[结论]在复发/转移的鼻咽癌患者中EBV-DNA有较高的检出率,且其表达水平较高,特异性高,对于EBV-DNA表达阳性且持续升高达≥1.0×103copies/ml的已治鼻咽癌患者,应高度警惕复发及转移。

[Purpose]To investigate the level and clinical significance of EBV-DNA in recurrence/ metastasis nasopharyngeal carcinoma （NPC） patients. [Methods ] The plasma EBV-DNA was de- tected by real-time PCR in 56 recurrence/metastasis nasopharyngeal carcinoma patients （including 25 cases with local recurrence,27 cases with distant metastasis,4 cases with local recurrence and distant metastasis）and 100 cases with clinical remission （control group）. [Results] Plasma EBV- DNA was detectable in 57.1% of all recurrence/metastasis patients （32/56）. The median concen- tration of EBV-DNA was 3845copies/ml in positive patients. The positive rate was 56.0% （14/25） in local recurrence patients ,while it was 51.8% （14/27）in distant metastasis patients and 100.0% （4/4） in local recurrence and distant metastasis patients. Moreover,plasma EBV-DNA was de- tectable in 4.0% （4/100） of patients with clinical remission,and the median concentration of E- BV-DNA was 179copies/ml in positive patients. [Conclusion] Plasma EBV-DNA is a significant biomarker with a high positive rate and level and high specificity. Positive expression of EBV- DNA,continuing to rise 1.0×103copies/ml in treated NPC patients,is alert to cancer recurrence and metastasis.