EB病毒DNA定量检测在鼻咽癌临床分期中的诊断价值

Diagnostic value of Epstein-Barr virus DNA detection in the clinical staging of patients with nasopharyngeal carcinoma

目的探讨EB病毒(EBV)DNA定量检测在鼻咽癌患者不同临床分期中的诊断价值。方法选取广东省汕头大学医学院附属粤北人民医院2013年3月至2015年12月500例病理诊断为鼻咽癌的患者作为研究组,同时选取200例健康体检人群作为对照组。2组同时采用荧光定量聚合酶链式反应(PCR)方法检测血浆EBV-DNA的表达量,并对2组之间及临床TNM分期I、Ⅱ与Ⅲ、Ⅳ的结果进行比较;再将其分别与酶联免疫吸附测定(ELISA)方法检测的血清EBV病毒壳抗原免疫球蛋白A(VCA-IgA)检测结果进行比较。结果荧光定量PCR方法检测EBV-DNA表达量中,研究组阳性率75.00%,对照组阳性率9.00%,两者差异有统计学意义(P<0.05)。鼻咽癌患者血浆EBV-DNA拷贝数与临床TNM分期呈正相关,差异有统计学意义(P<0.05);鼻咽癌分期越晚,血浆EBV-DNA拷贝数越高。结论血浆EBV-DNA水平与鼻咽癌患者临床TNM分期有显著相关性,可作为评估鼻咽癌患者临床分期的1种辅助性分子生物指标,具有较高应用价值。

Objective To discuss the diagnostic value of Epstein-Barr virus DNA（EBV-DNA）detection in the clinical TNM staging of patients with nasopharyngeal carcinoma（NPC）.Methods A total of 500 patients with NPC were selected as research group from March 2013 to December 2015 analyzed.At the same time,200 healthy people were chosen as control group.By real time quantitative PCR,the level of EBV-DNA in plasma was detected in all the subjects and compared between the two groups as well as between Ⅰ,Ⅱ,Ⅲ and Ⅳ staging.In addition,using enzyme-linked immunosorbent assay（ELISA）,serum EBV coat antigens-IgA（VCA-IgA）were detected.Results The positive rate of plasma EBV-DNA in research group（75.00%）was significantly higher than that of control group（9.00%,P〈0.05）.The copy numbers of plasma EBV-DNA in patients with NPC was positively correlated with TMN staging（P〈0.05）,the later the TNM staging,the more the copy numbers of plasma EBV-DNA.ConclusionThe plasma level of EBV-DNA is correlated with TNM staging of patients with NPC.Detection of plasma EBV-DNA is valuable for the diagnosis of NPC which can be used as an auxiliary molecular biological index for TNM staging.