吸烟对鼻咽癌患者治疗前血浆EBV-DNA表达和预后的影响

Effect of smoking on the expression of plasma Epstein-Barr Virus DNA pretreatment and the prognosis of patients with nasopharyngeal carcinoma

目的:研究吸烟与鼻咽癌(nasopharyngeal carcinoma,NPC)患者治疗前血浆EB病毒DNA(Epstein-Barr virus DNA,EBV-DNA)表达情况和预后的关系。方法 :选取首次确诊的477例男性NPC患者并留存治疗前静脉血,q RT-PCR检测NPC患者血浆EBV-DNA并计算吸烟指数,比较分析吸烟与NPC患者治疗前血浆EBV-DNA表达和预后的关系。结果:NPC患者的吸烟指数在治疗前T分期、N分期、M分期、临床分期等方面差异均无统计学意义(P>0.05)。不吸烟组与吸烟组EBVDNA阳性率和EBV-DNA拷贝数均无显著性差异(P=0.585,P=0.528);同时,不吸烟组与少量吸烟组和大量吸烟组EBVDNA阳性率和EBV-DNA拷贝数均无显著性差异(P=0.665,P=0.694);NPC患者的吸烟指数与治疗前血浆EBV-DNA拷贝数无显著相关性(P=0.536)。不吸烟组与吸烟组的肿瘤复发率和死亡率均无显著性差异(P=0.820,P=0.896),两组患者的无复发生存率和总生存率均无统计学差异(P=0.394,P=0.721);不吸烟组与少量吸烟组和大量吸烟组的肿瘤复发率和死亡率均无显著性差异(P=0.450,P=0.799),3组患者在无复发生存率和总生存率均无统计学差异(P=0.458,P=0.551)。Cox比例风险模型分析显示:T分期、N分期、M分期和治疗前EBV-DNA≥1 500 copies/m L是影响NPC患者无复发生存期的危险因素(P<0.05);年龄≥46岁、T分期、N分期、M分期和治疗前EBV-DNA≥1 500 copies/m L是影响NPC患者总生存期的危险因素(P<0.05);吸烟并不是影响NPC患者无复发生存期和总生存期的危险因素(P=0.946,P=0.673)。结论:吸烟对NPC患者治疗前血浆EBV-DNA表达和预后无显著影响。

Objective：To study the relationship between smoking and the expression el plasma EBV-DNA pretreatment and the prognosis of patients with nasopharyngeal carcinoma. Methods： Plasma EBV-DNA in 477 male NPC patients in this study were quantified by quantitative real time polymerase chain reaction, and the smoking index was calculated. The relationship between smoking and plasma EBV-DNA pretreatment and the prognosis was analyzed. Results： It was found that the tumor classification, lymph node status, metastasis status smoking index had no relationship with clinical stage of and overall stage of NPC patients （P 〉 0.05）. Next, there was no significant difference in the positive rate and the copies of plasma EBV-DNA between the nonsmoking group and the smoking group （P = 0.585, P = 0.528）. Also there was no significant difference in the positive rate and the copies of plasma EBV-DNA among the nonsmoking group, the light smoking group and the heavy smoking group（P = 0.665, P = 0.694）. And the smoking index had no relationship with the copies of plasma EBV-DNA pretreatment（P = 0.536）. There was no significant difference in relapse and mortality between the two groups or among the three groups. As a result, the risks for NPC relapse were clinical stage of tumor classification, lymph node status, metastasis status and plasma EBV-DNA pretreatment. And the risks for NPC mortality were age, clinical stage of tumor classification, lymph node status, metastasis status and plasma EBV-DNA pretreatment. However, smoking was not the risks for NPC relapse and mortality （P = 0.946, P = 0.673）. Conclusions：Smoking has no effect on plasma Epstein-Barr Virus DNA pretreatment and the prognosis of patients with nasopharyngeal carcinoma.