恶性肿瘤患者放疗后人巨细胞病毒感染的研究

Prevalence of human cytomegalovirus infections in malignant tumor patients after radiotherapy

目的分析恶性肿瘤患者放疗后人巨细胞病毒(HCMV)感染的状况,以提高诊断率。方法选取2012年6月-2013年12月在医院就诊的106例肿瘤患者,其中53例经过放疗治疗为放疗组,53例未接受放疗的为未放疗组,另选取53名健康受试者为对照组,采用酶联免疫法检测血清中HCMV-IgM抗体的水平,同时用实时定量PCR方法检测HCMV-DNA的含量,比较3组HCMV感染率。结果放疗组、未放疗组和对照组受试者的HCMV-IgM抗体检出率分别为16.9%、9.4%、1.9%;放疗组与未放疗组患者血清中HCMV-IgM抗体的检出率差异无统计学意义,放疗组、未放疗组与对照组的抗体检出率差异有统计学意义(P<0.05);放疗组、未放疗组和对照组患者的HCMV-DNA检出率分别为39.6%、22.6%和3.8%;放疗组与未放疗组患者及对照组血清中HCMV-DNA检出率的差异有统计学意义(P<0.05),未放疗组患者与对照组比较差异也有统计学意义(P<0.05);实时定量PCR方法检测HCMV活动性感染率的敏感性要高于酶联免疫法。结论肿瘤患者HCMV的感染率增高,放疗后HCMV的感染率进一步增加,实时定量PCR的方法检测HCMV感染率敏感性较高。

OBJECTIVE To investigate the prevalence of human cytomegalovirus （HCMV） infections in the malig‐nant tumor patients after radiotherapy so as to raise the diagnosis rate .METHODS A total of 106 tumor patients who were treated in the hospital from Jun 2012 to Dec 2013 were enrolled in the study ,53 patients who underwent the radiotherapy were assigned as the radiotherapy group ,and 53 patients who did not undergo the radiotherapy were set as the non‐radiotherapy group ;meanwhile ,53 healthy people were recruited as the control group .The levels of serum HCMV‐IgM were determined by using enzyme‐linked immunosorbent assay ,the contents of HC‐MV‐DNA were detected by means of real‐time quantitative PCR ,and the incidence of HCMV infection was com‐pared among the three groups .RESULTS The detection rate of HCMV‐IgM antibody was 16 .9% in the radiothera‐py group ,9 .4% in the non‐radiotherapy group ,1 .9% in the control group ;there was no significant difference in the detection rate of serum HCMV‐IgM antibody between the radiotherapy group and the non‐radiotherapy group , there was significant difference in the detection rate of the antibody among the radiotherapy group ,non‐radiothera‐py group ,and the control group （P〈0 .05） .The detection rate of HCMV‐DNA was 39 .6% in the radiotherapy group ,22 .6% in the non‐radiotherapy group ,3 .8% in the control group ,there was significant difference in the detection rate of serum HCMV‐DNA among the radiotherapy group ,non‐radiotherapy group ,and the control group （P〈0 .05） ,and there was also significant difference between the non‐radiotherapy group and the control group （P〈0 .05） .The sensitivity of the real‐time quantitative PCR was higher than that of the enzyme‐linked im‐munosorbent assay in the detection of HCMV active infections .CONCLUSION The incidence of HCMV infections is increased in the tumor patients and is further increased after the radiotherapy .The sensitivity of the real‐time quantitative PCR is relatively high in the detection of HCM V infections .